If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
The consumers of the products seem to find its shitness scant encumbrance.
NEW: Johnson calling for Sir Bernard Jenkin to resign from the Privileges Committee after not denying that he attended a lockdown breaking birthday party for his wife on 08 December 2020... with cake.
So Bozo things attending such an event is a resignation matter.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
The 10 for Uxbridge is probably value, if the Tories can turn it into a referendum on ULEZ, rather than a referendum on Boris Johnson.
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
It's a big roundabout.
But sadly, no Swiss Cottage?
It is named after the pub at the Northern end of the "Island"*, which is both (a) called The Swiss Cottage and (b) looks vaguely like one (if you've had a few).
* I say "island", but it's pretty huge.
Here you go:
It has always intrigued me. For the Tube to be named after the pub that means the pub must be surprisingly old, even tho it looks like naff 1960-70s pastiche
The tube station opened in 1939, it was part of the Bakerloo back then. Transferred to the (then) new Jubilee line in 1979.
The story might be a little more complicated. It seems it was once a Metropolitan line station, so opened in 1868. It also seems very odd to challenge you Mr P on a railway fact! (I live nearby though so, was pretty sure 1939 was wrong). Undoubtedly there's more detail.
(I've always hoped that the Met line might re-commission Lord's station. When I was young I always wondered what the odd 'ruins' were, and then with the onset of the internet I found out. It'd be so handy!)
I worked on this campaign, so I can explain (I live in St Albans and am a local Green activist).
St Albans is essentially a London suburb - lots of commuters into the City, lots of nice green space, lots of big houses and fancy schools. Whilst it voted Lab in '97 at a parliamentary level, it has typically been Tory or LD. It's a lot of people who might be Tory for economic reasons, LD for social reasons, and specifically not Labour for class reasons.
This specific seat is the town centre seat - a higher percentage of graduates, relatively high income, whilst also having high turnover and younger voters. It is also one of the few places in Hertfordshire that voted Remain over Leave (I think by like 60 / 40). So the LDs won the parliamentary seat in '19 and have been really strong since.
The LDs and Cons have typically swapped control of the council on small margins and periods of NOC. Before '22 the council was LD led, with the LDs and Cons on an equal number of councillors and one Green (in this ward) and a few independents and Labour councillors. In '22 the boundaries changed, and an all up election was held (St A usually does elections in thirds every year, with one off year for county elections). In that election the Cons were wiped out to 4 or 5 elected councillors, Lab lost all their councillors and the Greens held their seat, as did one or two independents. The LDs took the rest, holding like 80% of the council.
At the last local election cycle the Green councillor was defending in this seat and had a LD challenger for the first time in a while since the Tories obviously couldn't win it (previously it was a three or even four way seat, with one year the Tories winning with only 26% of the vote, and we've had a local pact with the LDs that they wouldn't stand against us if we supported them leading the council in NOC scenarios). Our councillor won, proving that he could beat the LDs. The greens also won in the neighbouring seat, which is also the ward of the LD council leader (although it wasn't him who was displaced, as he's not up til next year). So two Green wins in very LD territory.
After the recent local elections a big issue turned up of tree felling - the local council said it was going to cut down 250 trees for health and safety reasons. Lots of local people didn't like this, and a pretty sizable number of people were willing to campaign on it. The local LDs, safe in their huge majority, essentially ignored it and said it was all words no action from Greens who don't know what running a council is like. Like Sheffield, this blew up a bit and became a story in the national cycle for a bit, with spots in the Times and radio interviews on LBC etc. A local member of neighbourhood who knows people, is involved in the allotments, volunteers with Greenpeace etc. wanted to run in the by election, so they did.
Then it was ground game, where we did a lot of work.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
Yes, I think the uninitiated look at Uxbridge and think 'London' - therefore bad for Tories. But Uxbridge is atypical of London. I also wonder whether perhaps the Tories have fallen as far as they can in London, whereas in the outer south east they have somewhat further to go.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
Putting end users anywhere near the top of the list of priorities for the NHS would be a multi-decadal task.
It wouldn't if that's where the money came from. Then watch them get off their fat haunches and give granny a drink of water.
Just found my new Party is proposing a maximum single bus fare of £1 in England believes in a wealth tax on assets over £2m and a universal basic income
Great to be in a Party with so many Policies I agree with
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
It isn't the right thing to do, it's utter bullshit. Particulate levels are far higher on the tube, which people will be forced to crowd into more by this unjust infringement of liberty.
One person's liberty to fill the air with harmful particulates takes away another person' s liberty to breathe clean air, so it is really a question of balancing competing liberties not infringing liberty. The ULEZ is an excellent policy, government action to eliminate a genuine, life-destroying problem. And I say this as someone who was forced to replace my car to comply with it.
Then you're doubly wrong. Emissions levels are not dangerously high, nor are they rising. They are, notably, orders of magnitude higher on the tube, where they are at levels recognised globally as dangerous. Doing something about this would undoubtedly be in the public interest, but there's no political effort to do so, because the LEZ policy isn't about harmful particulates, it's about taking peoples' cars away. I'm glad you were able to afford to replace your car. Many won't be, and thus a great pillar of 20th century freedom and prosperity comes under threat.
The particularly irksome thing about the ULEZ is that it's so much expense (mostly for the poor) for so little gain. It's only bringing forward the natural process of replacing the vehicle stock with new. In ten years time it won't be making a difference to air quality any more, the vehicle stock would have been replenished anyway. It's a very expensive way to marginally improve air quality for such a short period of time.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
The 10 for Uxbridge is probably value, if the Tories can turn it into a referendum on ULEZ, rather than a referendum on Boris Johnson.
It’s a ULEZ ref for every resident in Uxbridge, apart from the surge in Hindu vote focussed only in supporting Sunak who they love.
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
It's a big roundabout.
But sadly, no Swiss Cottage?
It is named after the pub at the Northern end of the "Island"*, which is both (a) called The Swiss Cottage and (b) looks vaguely like one (if you've had a few).
* I say "island", but it's pretty huge.
Here you go:
It has always intrigued me. For the Tube to be named after the pub that means the pub must be surprisingly old, even tho it looks like naff 1960-70s pastiche
The tube station opened in 1939, it was part of the Bakerloo back then. Transferred to the (then) new Jubilee line in 1979.
The story might be a little more complicated. It seems it was once a Metropolitan line station, so opened in 1868. It also seems very odd to challenge you Mr P on a railway fact! (I live nearby though so, was pretty sure 1939 was wrong). Undoubtedly there's more detail.
(I've always hoped that the Met line might re-commission Lord's station. When I was young I always wondered what the odd 'ruins' were, and then with the onset of the internet I found out. It'd be so handy!)
Actually, the current (ex-Bakerloo, now Jubilee) platforms opened in 1939, allowing the Met platforms to close! So there!
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
It's a big roundabout.
But sadly, no Swiss Cottage?
It is named after the pub at the Northern end of the "Island"*, which is both (a) called The Swiss Cottage and (b) looks vaguely like one (if you've had a few).
* I say "island", but it's pretty huge.
Here you go:
It has always intrigued me. For the Tube to be named after the pub that means the pub must be surprisingly old, even tho it looks like naff 1960-70s pastiche
It's not the only tube station that was named after a pub.
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Not just their core vote, 59% of voters overall oppose allowing more homes to be built on the greenbelt.
If Starmer becomes PM and as he suggests he will do goes beyond building more houses on brownbelt land to allowing much more development in the greenbelt he will face huge opposition, especially in the South and outer London surbubs (even if he does win Bart's vote)
Do any of the 59% have a plan for where everyone is going to live in the decades ahead? Tent shanty-towns in Surrey I suppose.
If we cut immigration significantly we wouldn't need so many new houses.
The UK birthrate is only 1.6 now, well below replacement level
Cutting inflation doesn't reduce prices, it means prices remain high and continue to rise at a slower rate.
Cutting immigration wouldn't mean we'd need fewer houses, it'd mean we'd still having a housing shortage and we'd continue to need even more houses per annum but at a lower rate.
Though you have failed to understand maths or numbers as per usual.
Most recent data is from 2021.
2021 Live Births: 694,685 2021 Deaths: 666,659
694,65 - 666,659 = Natural population growth of 28,026
Birth rate has been below 'replacement level' in theory since 1973. In the past 50 years birth rate has exceeded death rate every single year except 2020 at the height of the pandemic and 1976, despite having a below replacement level birth rate that entire time.
Is it wrong to want another seven deaths?
Beastly. Beastly
Hang on. I thought I understood demographics, but I clearly don't, and if I can't ask anonymously on an internet forum when can I ask. How is that 1.6 calculated if births is exceeding deaths? I must be missing something obvious here.
The 'birthrate' here is births per woman, I think (rather than births per 1000 population, for example). As you need two people to make a child, both of whom will eventually die, you need two births per woman on average for steady state (assumes equal numbers of men and women, but it's thereabouts).
With no immigration and a fixed life expectancy, births over 2 leads to rising population, under 2 leads to falling population. If you have growing life expectancy then population could still increase, for a time, at a lower than 2 level (as babies born faster than deaths). Consider for example two couples move to an uninhabited island; each has only one child (so below replacement) but before they die those two children provide three grandchildren. The population has risen from 4 to 9, but the birth rate is only 5/3 = 1.7
ETA: Even when the four original inhabitants die, population has risen to 5, even assuming there are no more new children. But if the number of births per woman stays below 2 it will drop eventually.
Gotcha. So number of births now is slightly greater than number of births 80-odd years ago - so births exceed deaths.
Exactly: even though women are - on average - having fewer that two children, population is held up by the fact that people had more children in the interim.
Feel slightly daft that I didn't grasp that straight away. Still, it would be a poor world where we couldn't appear slightly daft anonymously on an internet chat forum from time to time.
On another subject, I am in the closing stages of 6 months of house renovation. I am running out of mugs suitable for giving to tradesmen - all the really appropriate ones have got lost or broken or left on a roof and filled full of mold. We're getting down to mugs which say 'For my Daddy on Father's Day' or 'Forever Friends' or some such. Lack of boring mugs has never been a problem in my life before - quite the reverse; the cupboard has been full to overflowing, and I am lamenting the careless ease with which I let go the mug advertising Wispa, the souvenir from South Uist, the boring grey one which no-one ever chose. Let this be a salutary lesson for all of you.
Just found my new Party is proposing a maximum single bus fare of £1 in England believes in a wealth tax on assets over £2m and a universal basic income
Great to be in a Party with so many Policies I agree with
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
The 10 for Uxbridge is probably value, if the Tories can turn it into a referendum on ULEZ, rather than a referendum on Boris Johnson.
It’s a ULEZ ref for every resident in Uxbridge, apart from the surge in Hindu vote focussed only in supporting Sunak who they love.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
The 10 for Uxbridge is probably value, if the Tories can turn it into a referendum on ULEZ, rather than a referendum on Boris Johnson.
It’s a ULEZ ref for every resident in Uxbridge, apart from the surge in Hindu vote focussed only in supporting Sunak who they love.
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
It's a big roundabout.
But sadly, no Swiss Cottage?
It is named after the pub at the Northern end of the "Island"*, which is both (a) called The Swiss Cottage and (b) looks vaguely like one (if you've had a few).
* I say "island", but it's pretty huge.
Here you go:
It has always intrigued me. For the Tube to be named after the pub that means the pub must be surprisingly old, even tho it looks like naff 1960-70s pastiche
The tube station opened in 1939, it was part of the Bakerloo back then. Transferred to the (then) new Jubilee line in 1979.
The story might be a little more complicated. It seems it was once a Metropolitan line station, so opened in 1868. It also seems very odd to challenge you Mr P on a railway fact! (I live nearby though so, was pretty sure 1939 was wrong). Undoubtedly there's more detail.
(I've always hoped that the Met line might re-commission Lord's station. When I was young I always wondered what the odd 'ruins' were, and then with the onset of the internet I found out. It'd be so handy!)
Actually, the current (ex-Bakerloo, now Jubilee) platforms opened in 1939, allowing the Met platforms to close! So there!
"The tube station opened in 1939", no mention of platforms being the arbiter.. so there back!
Apart from living quite close, and always having lived in that area, my brother happens to work as a driver on the Bakerloo. Before you get your nose out of joint.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
90%+ of Labour supporters tend to vote for the LDs in by-elections where they're the best way to beat the Tories. Chesham and Amersham being a good example. The opposite isn't always true to the same extent.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
Just found my new Party is proposing a maximum single bus fare of £1 in England believes in a wealth tax on assets over £2m and a universal basic income
Great to be in a Party with so many Policies I agree with
SKS Tories offers nothing for people like me
I can see the environmentalism angle in the first of those. The other two? Nah.
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
The 10 for Uxbridge is probably value, if the Tories can turn it into a referendum on ULEZ, rather than a referendum on Boris Johnson.
It’s a ULEZ ref for every resident in Uxbridge, apart from the surge in Hindu vote focussed only in supporting Sunak who they love.
My mum hates him :
My Dad likes him. 😝
The reason is, he sees Sunak as completely dismantling everything Johnson.
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
It's a big roundabout.
But sadly, no Swiss Cottage?
It is named after the pub at the Northern end of the "Island"*, which is both (a) called The Swiss Cottage and (b) looks vaguely like one (if you've had a few).
* I say "island", but it's pretty huge.
Here you go:
It has always intrigued me. For the Tube to be named after the pub that means the pub must be surprisingly old, even tho it looks like naff 1960-70s pastiche
The tube station opened in 1939, it was part of the Bakerloo back then. Transferred to the (then) new Jubilee line in 1979.
The story might be a little more complicated. It seems it was once a Metropolitan line station, so opened in 1868. It also seems very odd to challenge you Mr P on a railway fact! (I live nearby though so, was pretty sure 1939 was wrong). Undoubtedly there's more detail.
(I've always hoped that the Met line might re-commission Lord's station. When I was young I always wondered what the odd 'ruins' were, and then with the onset of the internet I found out. It'd be so handy!)
Actually, the current (ex-Bakerloo, now Jubilee) platforms opened in 1939, allowing the Met platforms to close! So there!
"The tube station opened in 1939", no mention of platforms being the arbiter.. so there back!
Apart from living quite close, and always having lived in that area, my brother happens to work as a driver on the Bakerloo. Before you get your nose out of joint.
Um, I was just testing you, honest, guv!
BTW have you visited every station in the "Greater TfL" contactless ticketing area? Out to places like Luton Airport, Reading, Gatwick, Hertford, etc. Like I have?
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
"Vote Conservative and we'll poison your children"
there was an anti ULEZ demo near my area of outer London earlier this year. My wife overheard someone at her hairdressers the next day saying, "did you go to the protest, I could only stay 30 minutes until the fumes got too much for me".
Zero awareness.
The Just Stop Oil team were at at again on London Bridge this morning.
I suppose the point still stands that if we wanted to use our cars less (for whatever reason, global warming, fumes, whatever) then we would use them less. But we don't.
I did smile that they were also blockading double-decker buses one of them literally trumpeting its electric/green credentials with bright green paintwork proclaiming "we care..."
Without getting sucked into another tedious Just Stop Oil debate, I think it's important to point out the "if we wanted to use our cars less ... then we would use them less" argument it crap. There are many behaviours that are undesirable that people would do if given free rein: stealing, for example.
If we need to decide whether something should be mandated, encouraged, allowed, discouraged, or banned, "because people want to" is not the only argument.
The default should be towards letting people do what they want when they want, but that's the starting point, not necessarily the end point.
Not your best analogy. You are saying that using your car is like stealing so measures must be put in place to stop both?
The default absolutely should be towards letting people do what they want but the protestors are preventing this (what they want being to drive their Bugatti Veyrons across London Bridge in accordance with the law).
If the elected government mandates using cars less (and they are forcing people to give up ICEs by the day after tomorrow in relative terms) then fine. But not randoms off the street in bright orange jackets.
It wasn't my intention to say that driving is akin to stealing. Full disclosure: I drive but do not steal. But I absolutely would steal SOME things SOME times if I could get away with it. Not habitually, but sometimes you see something nice that someone has and you feel they don't deserve it. You know how it is. Anyway, I don't act on it due to societal and legal disincentives.
And there's a point. Not all disincentives come from legislation. There are social pressures too. And social pressures on governments to allow or disallow certain things. That's where JSO come in. They're trying to drive a change they believe in that the government obviously doesn't. Now, I'm not going to judge them either way, that's for others. But I do think a similar aim of reducing ICE use is a worthwhile goal, because the noise and pollution they create aren't very nice. I like the idea of them being discouraged. That's not the same as saying block all the bridges and tax us drivers out of existence.
My untrammelled freedom to drive is someone else trammelled freedom to breath clean air, so whatever our final views, we deserve to at least consider arguments beyond drivers just being allowed to do what they like.
But doesn't god say do not steal? How can you go against the Big Man?
There are no gods. Not Shiva nor Jaweh nor Allah nor Thor.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
"Vote Conservative and we'll poison your children"
there was an anti ULEZ demo near my area of outer London earlier this year. My wife overheard someone at her hairdressers the next day saying, "did you go to the protest, I could only stay 30 minutes until the fumes got too much for me".
Zero awareness.
The Just Stop Oil team were at at again on London Bridge this morning.
I suppose the point still stands that if we wanted to use our cars less (for whatever reason, global warming, fumes, whatever) then we would use them less. But we don't.
I did smile that they were also blockading double-decker buses one of them literally trumpeting its electric/green credentials with bright green paintwork proclaiming "we care..."
Without getting sucked into another tedious Just Stop Oil debate, I think it's important to point out the "if we wanted to use our cars less ... then we would use them less" argument it crap. There are many behaviours that are undesirable that people would do if given free rein: stealing, for example.
If we need to decide whether something should be mandated, encouraged, allowed, discouraged, or banned, "because people want to" is not the only argument.
The default should be towards letting people do what they want when they want, but that's the starting point, not necessarily the end point.
Not your best analogy. You are saying that using your car is like stealing so measures must be put in place to stop both?
The default absolutely should be towards letting people do what they want but the protestors are preventing this (what they want being to drive their Bugatti Veyrons across London Bridge in accordance with the law).
If the elected government mandates using cars less (and they are forcing people to give up ICEs by the day after tomorrow in relative terms) then fine. But not randoms off the street in bright orange jackets.
It wasn't my intention to say that driving is akin to stealing. Full disclosure: I drive but do not steal. But I absolutely would steal SOME things SOME times if I could get away with it. Not habitually, but sometimes you see something nice that someone has and you feel they don't deserve it. You know how it is. Anyway, I don't act on it due to societal and legal disincentives.
And there's a point. Not all disincentives come from legislation. There are social pressures too. And social pressures on governments to allow or disallow certain things. That's where JSO come in. They're trying to drive a change they believe in that the government obviously doesn't. Now, I'm not going to judge them either way, that's for others. But I do think a similar aim of reducing ICE use is a worthwhile goal, because the noise and pollution they create aren't very nice. I like the idea of them being discouraged. That's not the same as saying block all the bridges and tax us drivers out of existence.
My untrammelled freedom to drive is someone else trammelled freedom to breath clean air, so whatever our final views, we deserve to at least consider arguments beyond drivers just being allowed to do what they like.
But doesn't god say do not steal? How can you go against the Big Man?
There are no gods. Not Shiva nor Jaweh nor Allah nor Thor.
Given the weather at the moment, I’d be a bit cautious about pissing off Thor!
Interesting to see that astuties such as hyufd and andy are of the view that the Cons are more likely to lose Beds than Ux. The betting is very much the opposite. They're 10 for Ux and only about 3 for Beds.
The 10 for Uxbridge is probably value, if the Tories can turn it into a referendum on ULEZ, rather than a referendum on Boris Johnson.
It’s a ULEZ ref for every resident in Uxbridge, apart from the surge in Hindu vote focussed only in supporting Sunak who they love.
My mum hates him :
Any particular reasons?
Several I think, his mannerisms, priviliged upbringing, non-dom wife, to name but a few.
And he's back to "respecting what local communities want" when it comes to NIMBYism and the total lack of housing.
Sunak doesn't get it and will never get my vote.
The conservatives are squeezed between what the country needs (infrastructure, housing) & what their core vote wants (build absolutely nothing anywhere).
Anyone who is fit to be Prime Minister should be able to show leadership on what the country needs.
Sunak doesn't. He's not fit to be in Downing Street.
Who is? Genuine question.
Hard to tell.
Boris did get the importance of this, though he was a coward after the by-election loss the Lib Dems and a rebellion by Theresa May and others.
Michael Gove has had good things to say in the past, but is the current relevant Secretary of State and has made things much worse not better.
Keir Starmer has said some good things recently, but he's an opportunist and has as much integrity as Boris so it will be interesting to see if he actually comes up with credible policies on this matter or whether he tacks to win the NIMBY vote too.
As much as I dislike Labour I'm starting to think the only way this issue might end up getting tackled is if there's a 1997-style Labour landslide that allows the Government to ignore the NIMBY squeals and pass the legislation the country desperately requires, putting the interests of the country ahead of NIMBY local election concerns.
An 80 seat Tory majority should have been allowed the Tories to tackle this issue themselves, but they've ran away from it instead, for shame.
What I don't get is that just about everywhere there is a presumption in favour of planning applications being granted.
So the private sector is doing its bit and we have many times rehearsed the pipeline and lifespan of a plot of ground to new house so I don't think "landbanking" is as much of a thing as people like sometimes to make out (see also: "foreign absentee landlords/empty properties").
So would you have the govt embark on a huge housebuilding programme and if so via what agents/process?
The problem is there's not a presumption in favour of planning applications being granted within a matter of days or weeks. There's the probability if you drag things out for years or decades through countless appeals that planning will eventually be granted but that's not good enough.
There should be certainty about your ability to have permission before you buy land and getting permission should not significantly change the value of land as a result, and the process should take days or weeks not years. Then small businesses can get involved.
If you're a small independent business with not much capital then you can't just build a home where its needed. You need to buy some land, hold onto it and hope that you get permission and that it doesn't take years to get that permission. And why do that without certainty you'll have the permission, which means they don't do it at all. The risk of not getting permission means it isn't worth investing your limited capital into land to develop.
In almost all the developed world without our Byzantine planning system and with a rational zoning system instead it is small developers build the majority of homes, often by only one home at a time, instead of large banks of estates by an oligopoly of large developers who control the market and face little competition thanks to the planning constraints that put off small competitors.
Hmm nothing to do with Nimbyism more to do with the significant externalities involved I wouldn't necessarily like such a system. Why wouldn't you build a house in the middle of the roundabout at the end of your road, for example?
Well I'm not sure who owns the roundabout, I'd have presumed the Council, so if the land's not for sale then I can't see it being an issue.
Also the roundabout isn't exactly big, I would have thought it'd be smaller than the plot needed to build a decent home. So again I'm doubtful it'd be an issue.
But if those obstacles can be overcome then I'm not sure I see the issue. I've seen buildings located insides roundabouts before, including pubs, Churches and others. There's even a house located within the M6 between the northbound and southbound carriages.
The Swiss Cottage roundabout has a pub in the middle of it. Quite a large one.
It also has a massive block of flats. And a cinema. And a kitchen supply store. And a Costa Coffee.
It's a big roundabout.
But sadly, no Swiss Cottage?
It is named after the pub at the Northern end of the "Island"*, which is both (a) called The Swiss Cottage and (b) looks vaguely like one (if you've had a few).
* I say "island", but it's pretty huge.
Here you go:
It has always intrigued me. For the Tube to be named after the pub that means the pub must be surprisingly old, even tho it looks like naff 1960-70s pastiche
The tube station opened in 1939, it was part of the Bakerloo back then. Transferred to the (then) new Jubilee line in 1979.
The story might be a little more complicated. It seems it was once a Metropolitan line station, so opened in 1868. It also seems very odd to challenge you Mr P on a railway fact! (I live nearby though so, was pretty sure 1939 was wrong). Undoubtedly there's more detail.
(I've always hoped that the Met line might re-commission Lord's station. When I was young I always wondered what the odd 'ruins' were, and then with the onset of the internet I found out. It'd be so handy!)
Actually, the current (ex-Bakerloo, now Jubilee) platforms opened in 1939, allowing the Met platforms to close! So there!
"The tube station opened in 1939", no mention of platforms being the arbiter.. so there back!
Apart from living quite close, and always having lived in that area, my brother happens to work as a driver on the Bakerloo. Before you get your nose out of joint.
Um, I was just testing you, honest, guv!
BTW have you visited every station in the "Greater TfL" contactless ticketing area? Out to places like Luton Airport, Reading, Gatwick, Hertford, etc. Like I have?
No, far from it. I guess I've only ever got off or on trains at 50% of the tube network, if that. (Which is probably still quite an achievement). Passing through - most of the network, but there are odd places like Mill Hill East where I've never been (to the station, although I have been to the area).
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
They tried that years ago - from memory the heart specialist who came out worst from the survey was the one who took the riskiest patients that no one else would touch.
Hence if you looked at the overall picture his results were terrible but if you just looked at the profile of his typical patient he was 50% better than everyone else on the list.
Strangely enough those lists stopped being published soon after they started.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
I'm sure these online parody accounts do a lot of damage to the Tories, because some people think they are real.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Mildy interestingly, SLab are majoring in doing down the ULEZ scheme in Glasgow (and I presume Edinburgh*). Quite how many 'working class people' drive to work in the centre of cities and therefore have parking provided by their employer or can afford huge parking charges is something upon which to ponder.
*Actually maybe not Edinburgh as they're in charge with help from the Tories there.
It is just a money spinner given the air quality is below all limits and therefore makes it just more grifting.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
They tried that years ago - from memory the heart specialist who came out worst from the survey was the one who took the riskiest patients that no one else would touch.
Hence if you looked at the overall picture his results were terrible but if you just looked at the profile of his typical patient he was 50% better than everyone else on the list.
Strangely enough those lists stopped being published soon after they started.
Even attempts at standardising mortality are problematic, due to being gameable. Not least because the group that established one such system also set up a consultancy to advise hospitals on how to optimise their scores!
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
Mildy interestingly, SLab are majoring in doing down the ULEZ scheme in Glasgow (and I presume Edinburgh*). Quite how many 'working class people' drive to work in the centre of cities and therefore have parking provided by their employer or can afford huge parking charges is something upon which to ponder.
I saw somewhere that Glasgow council had to replace 600 vehicles to comply with their own emissions standard
Best one is their tow trucks to remove illegally parked vehicles etc are banned as they do not meet criteria.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
+1 - suddenly their old car is worth £1000 less and a suitable replacement £1000+ more and they didn't want to change in the first place.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
It's more about the overall great service though (which the premium pays for). The nicer rooms, better food, less stressed (and so having more time/nicer) staff, the shorter waiting lists.
I've never encountered anyone saying they're going private because the standardised mortality in the local Nuffield is so much lower (which it may well be, but partly because the privates generaly do more of the routine stuff).
We were supposed to accept open door immigration because of a horrific image of a dead baby on a beach, but the child murders and rapes of Rotherham were politely ignored because their plight did not align with a fashionable campaign or desired change in the law.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
+1 - suddenly their old car is worth £1000 less and a suitable replacement £1000+ more and they didn't want to change in the first place.
You would think there would be scope, from the charges, to provide means-tested support for change of vehicle to those who could show a genuine need to drive into the zone, i.e. work etc where public transport was not viable (you would, afterall, only need to do it as a one-off). London ULEZ apparently raised over £224m last year
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
They don't seem to. Look at the recent Cygnet, Priory and Elysium mental health scandals.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
We were supposed to accept open door immigration because of a horrific image of a dead baby on a beach, but the child murders and rapes of Rotherham were politely ignored because their plight did not align with a fashionable campaign or desired change in the law.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
I'm sure these online parody accounts do a lot of damage to the Tories, because some people think they are real.
Again, not a great surprise that you see the concept of people reviewing their NHS experiences, and others reading and making choices based on those reviews and scores to be so risible. You're a miserable and almost pathologically unimaginative poster who would throw away a winning lottery ticket whilst angrily moaning about litter.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
The thing that confuses me about Glasgow is that the M8 runs straight through the middle of it. That must be the biggest source of air pollution?
There is a nascent campaign to demolish it, which I would support - the motorway ruins the city in more ways than just pollution. And the layout of Glasgow is perfect for a publicly owned bus and tram system, and the streets wide enough for Dutch-style cycle infrastructure.
The ULEZ seems like the wrong intervention. Cheap though.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
Heh, I often buy that here, from supermarkets. It is a nice one though.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
If it's 'Belgian style' its pretty hard to imagine that the brewers think it's the best beer in the world.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
It's more about the overall great service though (which the premium pays for). The nicer rooms, better food, less stressed (and so having more time/nicer) staff, the shorter waiting lists.
I've never encountered anyone saying they're going private because the standardised mortality in the local Nuffield is so much lower (which it may well be, but partly because the privates generaly do more of the routine stuff).
When I worked in a private hospital……. big mistake by the way ….. if anything went amiss in the operating theatre it was straight on the phone to the nearest NHS General and the ambulance service, and off the patient went to be sorted out by the NHS.
Did I miss the big reveal about where @Leon is staying?
I was looking for an interesting small town in Virginia with some history, on my roadtrip back to Cincinnati. And I found Staunton. End of Shenandoah valley. Beautiful landscapes and quaint little downtown
Most good hotels are really pricey. Even average ones costly. America is expensive. Then I found one which is cheap. REALLY cheap. AND it’s beautiful.
So I thought. Something is up. Why is it so cheap? A beautiful 1820s mansion designed by a protege of Jefferson? Turns out it was a lunatic asylum and a prison. And it really was. Doors are cell doors
Then I arrived here and found that the atmosphere was even creepier and weirder than I expected. And I sat down on the hotel terrace in the dusk and did some research and discovered this
Basically the whole place was run by a Nazi doctor who forcibly sterilised and lobotomised thousands of poor white hillbilly girls who were forced out of Shenandoah national park
It’s like staying in a SS laboratory complex. That’s why suites are £70 not £500
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
You can get that from my local in Buckinghamshire. It is good. They serve it with a slice of orange.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
The thing that confuses me about Glasgow is that the M8 runs straight through the middle of it. That must be the biggest source of air pollution?
There is a nascent campaign to demolish it, which I would support - the motorway ruins the city in more ways than just pollution. And the layout of Glasgow is perfect for a publicly owned bus and tram system, and the streets wide enough for Dutch-style cycle infrastructure.
The ULEZ seems like the wrong intervention. Cheap though.
Glasgow is odd. Terrible private bus service. The subway. Buchanan Street pedestrianised since the 70s. A massive motorway straight through the middle.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
I think John Major's Patients' charter was a solid step forward, abandoned by Labour. But party politics can really be put to one side post 97 - Lab, Con, and Lib are all the parties of spaffing public money at an unreformed, unaccountable, and insatiable (for public money) NHS.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
The thing that confuses me about Glasgow is that the M8 runs straight through the middle of it. That must be the biggest source of air pollution?
There is a nascent campaign to demolish it, which I would support - the motorway ruins the city in more ways than just pollution. And the layout of Glasgow is perfect for a publicly owned bus and tram system, and the streets wide enough for Dutch-style cycle infrastructure.
The ULEZ seems like the wrong intervention. Cheap though.
Glasgow is odd. Terrible private bus service. The subway. Buchanan Street pedestrianised since the 70s. A massive motorway straight through the middle.
Caught between two very different philosophies?
Or infrastructure running behind the change in industries? I am obviously too young to have experienced it, but the decline in shipbuilding (mainly to the west of the city) and the growth of other industries in Glasgow must have caught urban planners out?
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
In the winter of 1999-2000, the NHS almost ground to a complete halt because of an outbreak of flu. Almost all non-emergency operations were cancelled, and the country at one point was left with just two intensive-care beds, with patients shuttled hundreds of miles in search of somewhere to stay.
The crisis was so severe it destroyed public faith in the NHS, and forced Tony Blair to launch a national plan to save it. A similar crisis was avoided last year only because the incidence of flu was unusually mild.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
It's more about the overall great service though (which the premium pays for). The nicer rooms, better food, less stressed (and so having more time/nicer) staff, the shorter waiting lists.
I've never encountered anyone saying they're going private because the standardised mortality in the local Nuffield is so much lower (which it may well be, but partly because the privates generaly do more of the routine stuff).
When I worked in a private hospital……. big mistake by the way ….. if anything went amiss in the operating theatre it was straight on the phone to the nearest NHS General and the ambulance service, and off the patient went to be sorted out by the NHS.
Whereas I, someone who was mucked up by the NHS, was fixed by private healthcare.
Ten years of on-and-off pain caused by the NHS; fixed privately.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
Unfortunately we hav eto pay for them for 40 years and they are long gone now, all the cash is sucked into paying crazy PFI costs
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
I'm sure these online parody accounts do a lot of damage to the Tories, because some people think they are real.
Again, not a great surprise that you see the concept of people reviewing their NHS experiences, and others reading and making choices based on those reviews and scores to be so risible. You're a miserable and almost pathologically unimaginative poster who would throw away a winning lottery ticket whilst angrily moaning about litter.
I won't delete, but will withdraw and apologise for the above remark. I try not to insult other posters (whilst happy to go to town on their posts). I failed in this instance.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
True, but a bottle from Molson-Coors, the world's third largest brewer, may not be the best example...
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
I don't disagree with any of that, but I also don't see the relevance to my point. Alder Hey (Con government). Bristol Heart Scandal (Con government). Contaminated Blood Scandal (both). Furness General Hospital scandal (Labour). Individuals and cultures were culpable in each, but it's not a specifically Labour thing.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
'Hasn't worked' is unfair. We have a mediocre health system for mediocre funding. It's about par on a value-for-money basis, maybe slightly better. You've had bad NHS experiences, perhaps that is steering your view. Private doesn't equal good and neither does it bring a net overall benefit via dynamic competition. Eg we went private with my mum recently. What it got us was access to the same resource we'd have had to wait longer for on the NHS. Same kit, same people. It was a queue jump. Brought nothing to the party other than allowing people who could pay to benefit at the expense of people who couldn't or wouldn't.
What we want is more and better aggregate medical resource, distributed efficiently to where it's most needed, regardless of the personality or social power or bank balance of the patient. So the question is how to achieve this. I don't know. I'm not an 'NHS envy of the world' person but I do want to stick with 'free at the point of provision'. If we ever go the market route for Health, that would be grim indeed. Money buys you plenty of advantages in life (always has, always will). Let's not make a point of adding to the list.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
If it's 'Belgian style' its pretty hard to imagine that the brewers think it's the best beer in the world.
New York pizza is "Italian style", and I challenge you to find a New Yorker who thinks the original is better.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
American beer, especially the craft varieties, the ales and IPAs, is pretty decent.
But let's not forget that America also gave us Coors Light.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
Heh, I often buy that here, from supermarkets. It is a nice one though.
But that’s the point. I wasn’t in a supermarket I bought that from a corner shop. They had a massive fridge with about 10-15 different craft beers. From IPAs to wheat beer to fruit beer and stout etc etc
You don’t get that selection, so ubiquitously, anywhere else in the world
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
I don't disagree with any of that, but I also don't see the relevance to my point. Alder Hey (Con government). Bristol Heart Scandal (Con government). Contaminated Blood Scandal (both). Furness General Hospital scandal (Labour). Individuals and cultures were culpable in each, but it's not a specifically Labour thing.
Okay, there's one way Stafford was different:
The NHS is a massive organisation, which employs a massive number of people. You will get people who do the wrong thing it, whether that be because they are wrong 'uns, ill-trained, uncaring, or just plain unlucky.
The same is true of any organisation. The key thing is for an organisation to detect when this is happening, and fix it - whether that be by more training, sacking negligent staff, or whatever.
At Stafford, for *years*, the leadership ignored it. The staff and the NHS cultists blamed the whistleblowers. Including the desecration of a whistleblower's mother's grave. And the Labour government gave them cover.
Given that the other members are I) Rod Liddle ii) Rod Liddle's chums and Iii) Rod Liddle's dog called Bernard, I'm not sure @bigjohnowls would find it congenial.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
It's more about the overall great service though (which the premium pays for). The nicer rooms, better food, less stressed (and so having more time/nicer) staff, the shorter waiting lists.
I've never encountered anyone saying they're going private because the standardised mortality in the local Nuffield is so much lower (which it may well be, but partly because the privates generaly do more of the routine stuff).
When I worked in a private hospital……. big mistake by the way ….. if anything went amiss in the operating theatre it was straight on the phone to the nearest NHS General and the ambulance service, and off the patient went to be sorted out by the NHS.
Whereas I, someone who was mucked up by the NHS, was fixed by private healthcare.
Ten years of on-and-off pain caused by the NHS; fixed privately.
Every sympathy. I’ve seen muck-ups in the NHS, too.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
If it's 'Belgian style' its pretty hard to imagine that the brewers think it's the best beer in the world.
New York pizza is "Italian style", and I challenge you to find a New Yorker who thinks the original is better.
Just found my new Party is proposing a maximum single bus fare of £1 in England believes in a wealth tax on assets over £2m and a universal basic income
Great to be in a Party with so many Policies I agree with
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
You've rather missed my point. I'm not saying the food (or clothes) market is inefficient. What I'm talking about is the right royal mess (plus dreadful inequities) that ensues when the 'consumer king, money talks' model is foisted on things that are unsuited to it. Eg education, energy, water, trains or ... Health.
Dear @BBCNews could you please stop saying how pleased we all are with continuing dry, sunny & hot weather? Our rivers & wetlands are dying & wildlife fading away. We need RAIN. It is good. You can’t make the weather, but please stop saying global heating is a positive thing.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
It's more about the overall great service though (which the premium pays for). The nicer rooms, better food, less stressed (and so having more time/nicer) staff, the shorter waiting lists.
I've never encountered anyone saying they're going private because the standardised mortality in the local Nuffield is so much lower (which it may well be, but partly because the privates generaly do more of the routine stuff).
Nah. It's the mortality. And the waiting. And the care. And the lack of neglect when you're there ie you are less ignored in a private hospital and routinely ignored in the NHS. Especially if you don't have a voice or are of the type not to ask.
John Rentoul @JohnRentoul · 16m Another notable Q earlier from Theresa Villiers: huge Tory cheer for an attack on Sadiq Khan's Ulez scheme – they really think its unpopularity might swing the Uxbridge by-election
ULEZ expansion is a big change and will certainly cost Labour votes.
It is probably the right thing to do but the 700,000 drivers who will have to pay or buy replacement cars are going to be far, far more likely to vote based on this issue than the several million who will gain marginally in air quality and less severe increases in fares/taxes elsewhere.
Not sure about that; it depends what figures you use. A lot of those 700,00 drivers (RAC figures) may never enter ULEZ; TfL estimates that 160,00 will be affected, and that 90.5% of vehicles in London are already ULEZ-compliant. I think loud, partisan voices are exaggerating the impact of ULEZ.
As ever it will be the poor sods that cannot afford to change vehicles that suffer.
The thing that confuses me about Glasgow is that the M8 runs straight through the middle of it. That must be the biggest source of air pollution?
There is a nascent campaign to demolish it, which I would support - the motorway ruins the city in more ways than just pollution. And the layout of Glasgow is perfect for a publicly owned bus and tram system, and the streets wide enough for Dutch-style cycle infrastructure.
The ULEZ seems like the wrong intervention. Cheap though.
Glasgow is odd. Terrible private bus service. The subway. Buchanan Street pedestrianised since the 70s. A massive motorway straight through the middle.
Caught between two very different philosophies?
Or infrastructure running behind the change in industries? I am obviously too young to have experienced it, but the decline in shipbuilding (mainly to the west of the city) and the growth of other industries in Glasgow must have caught urban planners out?
Perhaps [edit] also to the point, the Tories tried to gerrymander it, breaking up the conurbation into different areas to carve our permanently blue-voting areas. That left the central area impoverished. But also Edinburgh and much of Lothian benefited from the LAs getting together to maintain the Edinburgh council buses as a wider Lothian Buses in public ownership. Not sure why Greater Glasgow didn't do that.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
And fantastically bad value for money. Lab spaffs money up the wall on everything including hospitals and of course the tide rises but the waste is so phenomenal that when the Cons come in they have to cut everything and round we go again. If Lab spent less and the Cons spent more it would be a happy compromise with fewer peaks and troughs.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
The Conservatives introduced Choose & Book where patients get a choice of which hospital when they go for a first outpatient appointment. This choice would make for happier patients and drive up standards, we were told. It didn’t work, as we wrote about here: https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-8-36 In practice, patients do not experience the level of choice supposedly present in the system. There isn’t a huge capacity in the system whereby people have lots of choices.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
You can get that from my local in Buckinghamshire. It is good. They serve it with a slice of orange.
Vaguely on topic - the bar on the ground floor of Redcar's (topical) Vertical Pier (upper levels closed on health and safety grounds) also sells it.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
I don't disagree with any of that, but I also don't see the relevance to my point. Alder Hey (Con government). Bristol Heart Scandal (Con government). Contaminated Blood Scandal (both). Furness General Hospital scandal (Labour). Individuals and cultures were culpable in each, but it's not a specifically Labour thing.
EXACTLY BINGO!
It is an NHS thing. Structurally it allows if not condones such behaviour and incidents because no one takes responsibility and no one is accountable so no one really cares. Not really, because the comebacks are few and far between.
I have in various instances been in and out of PALS (when it's open, which is not often) so many times it makes my head spin and, like many service providers you have to be prepared to pursue your claim in the face of opposition and NHS sainthood.
The NHS system produces people who work for it who don't really care and that's the problem.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
I don't disagree with any of that, but I also don't see the relevance to my point. Alder Hey (Con government). Bristol Heart Scandal (Con government). Contaminated Blood Scandal (both). Furness General Hospital scandal (Labour). Individuals and cultures were culpable in each, but it's not a specifically Labour thing.
Good health stuff = good old NHS. Bad health stuff = wicked old government. This is game playing. Government is minimally involved except in writing cheques. They have no idea how to do a knee replacement or how to maintain the moral stature of NHS staff so that good stuff is normal and bad stuff amazingly rare.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
It's Topping - best to just ignore his bullshit or ask him to provide the evidence to back it up...
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
Reminds me of "the Post Office is always right" attitude that led to the Horizon fiasco.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
Reminds me of "the Post Office is always right" attitude that led to the Horizon fiasco.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
As you are now in highlands of Virginia (I think) and as theology is currently hot PB topic, here is link to a great song greatly performed on the movie "Oh Brother Where Art Thou"
Made famous by the late, great Dr. Ralph Stanley, from the mountains of southwest VA.; the movie version by the "Soggy Mountain Boy" is a true tribute to Stanley and his band, the Clinch Mountain Boys".
Who was perhaps the most prominent member of the Primitive Bapist Universalist Church, a very small fundamentalist denomination notable for belief that there is no Hell for anyone after death, because Christ attoined for ALL, and "it's hell enough on earth.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
It's Topping - best to just ignore his bullshit or ask him to provide the evidence to back it up...
Obviously we're trying to be polite on this forum but you are a fucking twat.
"The UK’s NHS performs worse than the average in the treatment of 8 out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years
It is the third poorest performer compared to the 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’).
It has consistently higher rates of death for babies at birth or just after (perinatal mortality), and in the month after birth (neonatal mortality): 7 in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries."
But then again on the bright side it "has the largest share of generic prescribing of all comparator countries, at 84 per cent in 2015 compared to an average of 50 per cent." Whatever the fuck that means.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
A family member was mistreated at Stafford during Labour's years in powers.
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
Reminds me of "the Post Office is always right" attitude that led to the Horizon fiasco.
Of course there are issues at private hospitals but ask anyone you know, perhaps you have experience yourself, and you will hear tales of routine neglect and low-level abuse in the NHS. Because as I say the structure of the NHS is such that there is no reason to care. Of course people care but they know that if someone dies then they were ill and there is likely to be no comeback or examination of the care provided. Not really. Unless someone like Letby goes off on one.
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
True, but a bottle from Molson-Coors, the world's third largest brewer, may not be the best example...
So Leon NOT (enough of) a beer snob? Always thought his pretensions somewhat suspect!
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
Heh, I often buy that here, from supermarkets. It is a nice one though.
But that’s the point. I wasn’t in a supermarket I bought that from a corner shop. They had a massive fridge with about 10-15 different craft beers. From IPAs to wheat beer to fruit beer and stout etc etc
You don’t get that selection, so ubiquitously, anywhere else in the world
Well, my local corner shop sells craft/real ale beers from the nearest town and at least one of the nearest cities. It doesn't sell US craft beers, as far as I know, but I doubt you find Selby bitter or BrewYork wares in a corner shop in the States.
But, I do agree with your substantive point that the US is right up there in the craft beer stakes.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
It's Topping - best to just ignore his bullshit or ask him to provide the evidence to back it up...
Obviously we're trying to be polite on this forum but you are a fucking twat.
"The UK’s NHS performs worse than the average in the treatment of 8 out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years
It is the third poorest performer compared to the 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’).
It has consistently higher rates of death for babies at birth or just after (perinatal mortality), and in the month after birth (neonatal mortality): 7 in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries."
But then again on the bright side it "has the largest share of generic prescribing of all comparator countries, at 84 per cent in 2015 compared to an average of 50 per cent." Whatever the fuck that means.
I dislike the NHS because it is bad at what it does and it is bad at what it does compared with other healthcare systems.
Tosser.
Question is- why is this so?
Is it because of poor staff attitudes because patients can't take their custom elsewhere?
Or is it because as a nation we've always skimped a bit and tried to get away with that by pushing money into staff numbers rather than buildings and machines that might help staff work more efficiently?
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Colour me non-surprised that the concept of people being empowered to make their own choices over their own healthcare has got you clutching your pearls. You think the British food sector is inefficient? I'd ask your political fellow traveller Rochdale Pioneers if that's true. And actually, it isn't true that there's a vast gulf between the diet that can be afforded by the rich and that afforded by those of modest income. The sector is brilliant at providing nutritious and delicious food to everyone. Abuses and frauds are low - the system is well regulated and choices clear. 'Unhelpful fetishization of choice' - beyond parody. The poor should suck up dying of c-diff or thirst in a shitty hospital and carry on voting Labour!
If they want shitty hospitals, the public should carry on voting Tory! For all Labour's faults - PFI! - there were real improvements in the NHS under 1997-2010 government.
And fantastically bad value for money. Lab spaffs money up the wall on everything including hospitals and of course the tide rises but the waste is so phenomenal that when the Cons come in they have to cut everything and round we go again. If Lab spent less and the Cons spent more it would be a happy compromise with fewer peaks and troughs.
It's quite good value for money and in many ways a bit shit. Kind of like the Iceland of healthcare. We'd perhaps be happier if it was the Lidl or Aldi, but such efficiencies would require a similar model of doing only a few things and doing them well. It's perhaps not surprising that acute care is where the better experiences of the NHS are generally found.
I'm not obsessed with the present NHS model, happy to switch it for one of the decent European ones, of which there are many. But they do also cost a bit more to deliver the better services some of them deliver.
(I'm currently battling the NHS on behalf of my parents, so I'm far from in love with it - my mother has a nonspecific and as yet undiagnosed condition and has been passed from specialist to specialist, ward to ward and no one cares - or perhaps no one has the time to care. Presently, the GP or the hospital have manged to lose/not send the discharge letter from her latest stay, which had instructions for further investigations which, as of yet, have not happened)
If the first three people to actually catch the newly pathogenic novel bat coronavirus were the three scientists working on pathologising a novel bat coronavirus in the special "pathogenic novel bat coronavirus lab" then, I submit, the evidence that it came from a fucking pangolin stew in a random market begins to look a tiny bit thin
“‘Oh, my God, there’s been an outbreak of chocolaty goodness near Hershey, Pa. What do you think happened?’ “Like, ‘Oh I don’t know, maybe a steam shovel mated with a cocoa bean?’ Or it’s the f…ing chocolate factory! Maybe that’s it?” - Jon Stewart.
I have tasted what Hershey make. It cannot be described as “chocolaty goodness”. Certainly not “goodness”. I’m not that convinced about “chocolaty”.
Very true, but he was talking to a mostly American audience, whose experience of ‘chocolate’ most likely emanates from that factory in Pennsylvania.
It is a sad country in many ways (and a wonderful one in others).
Life with shit chocolate and shit cheese. Unbearable.
Beer not too bad, mind. Had some very nice ones when over there a couple of times. But not enough to make me move.
Actually, I’d say American beer - in variety and innovation and ubiquity - is now the best in the world
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
True, but a bottle from Molson-Coors, the world's third largest brewer, may not be the best example...
So Leon NOT (enough of) a beer snob? Always thought his pretensions somewhat suspect!
By the way, have you been to Machine House brewery, in Seattle? Fine english-style ales and an interesting building.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
It's Topping - best to just ignore his bullshit or ask him to provide the evidence to back it up...
Obviously we're trying to be polite on this forum but you are a fucking twat.
"The UK’s NHS performs worse than the average in the treatment of 8 out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years
It is the third poorest performer compared to the 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’).
It has consistently higher rates of death for babies at birth or just after (perinatal mortality), and in the month after birth (neonatal mortality): 7 in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries."
But then again on the bright side it "has the largest share of generic prescribing of all comparator countries, at 84 per cent in 2015 compared to an average of 50 per cent." Whatever the fuck that means.
I dislike the NHS because it is bad at what it does and it is bad at what it does compared with other healthcare systems.
Tosser.
Question is- why is this so?
Is it because of poor staff attitudes because patients can't take their custom elsewhere?
Or is it because as a nation we've always skimped a bit and tried to get away with that by pushing money into staff numbers rather than buildings and machines that might help staff work more efficiently?
Well to start with we've always skimped a bit. And we evidently don't want to spend more than we do on it, if that's the problem. But as I have said (a couple of times...) the culture of the NHS does not lend itself to individual responsibility and accountability because most sins apart from the most egregious can be hidden amongst the morass.
Does it matter if your granny isn't given a bedpan or water or her drugs for a couple of days? Not really. What's granny going to do and you're not there to shout about it. So it happens. Often. And no I don't have the stats but ask 10 of your friends and many of them will have had such experiences.
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
It's Topping - best to just ignore his bullshit or ask him to provide the evidence to back it up...
Obviously we're trying to be polite on this forum but you are a fucking twat.
"The UK’s NHS performs worse than the average in the treatment of 8 out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years
It is the third poorest performer compared to the 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’).
It has consistently higher rates of death for babies at birth or just after (perinatal mortality), and in the month after birth (neonatal mortality): 7 in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries."
But then again on the bright side it "has the largest share of generic prescribing of all comparator countries, at 84 per cent in 2015 compared to an average of 50 per cent." Whatever the fuck that means.
I dislike the NHS because it is bad at what it does and it is bad at what it does compared with other healthcare systems.
Tosser.
Sure we could have better a better NHS and therefore better healthcare if we were prepared to spend more per head on it.
Dr Jennifer Dixon, Chief Executive of the Health Foundation said: "Compared to the other 18 countries the UK has middling funding and middling performance overall."
Paul Johnson, Director of the Institute for Fiscal Studies said: "The truth about the NHS is that by international standards it is a perfectly ordinary healthcare system, providing average levels of care for a middling level of cost."
Sam Freedman had posted a good article, based on a detailed investigation, on what’s wrong with the NHS.
In large part, we just don’t bother investing in capital infrastructure (beds, CT machines, computer systems). We are strikingly out of sync with global norms.
But rather, it's such a large institution with no proper management or accountability that many of its employees don't really care about the level of service that is dispensed to its "customers". If they lose a few patients here and there unless they have been unplugging the life support machine to do the hoovering they know that no one will really know or care.
Apart from the family, obvs, but they, together with the patients, are the least important part of the NHS as far as the NHS is concerned.
OK. Did you read the article?
Of course not. I relied on you to precis it for me. We can't go around reading all the articles posted on PB. That is why we have posters posting posts.
Fair.
Low levels of capital investment was one of three issues cited. The others were loss of experienced staff and replacement with inexperienced ones, probably exacerbated by Brexit; and poor and under-resourced management, confounded by pisspoor target-setting by central government.
When you add the above to the massive backlog created by Covid, you get the current collapse.
The NHS's issues are the same as most public sector body's issues - a perverse incentive flow. Money comes from the Government. More money comes when the service is seen to be in need, even more comes when it is in crisis. If the money came instead from the end users, who were able to choose which treatment providers to patronise, medical treatment would be more like food shopping, and the better for it. The same goes for schools.
If you want to see perverse incentives, check out the US health system.
Indeed, but again there, the incentive flow is f-d up, because most US policies are designed for someone to make a vast profit.
The US health system is effectively a massive tax on the US economy. It likely flatters US GDP figures (in total and per capita), and takes money away from US consumers who would be even RICHER than European counterparts.
I don't know enough about it to really comment, but I can well believe you. The USA system is usually held up as the bogeyman to those against the 'privatisation' of the NHS. But that's really a false choice. What the NHS needs is the empowerment of the health consumer. Health budget allotment should follow the user and be paid upon their successful departure from the system, alive and well. That would completely remove the need to battle all the dragons - waste, lack of attentiveness, lack of appropriate facilities - all of it.
Giving end users choice can be an effective way to allocate resources, but you need people to make some sort of informed choice. Healthcare is very, very technical. Most people do not have the requisite knowledge to make many of the choices. We should listen to service users more, both at an individual level and in terms of planning, but I am sceptical of these claims that if only we had individual health budgets, everything would suddenly work.
I think things are a good deal simpler than we give them credit for. Bad hospitals kill lots of people, for a start. Yes, there are nuances, but in a consumer-led system, you would have something like TripAdvisor for hospitals.
We don't want everyone shopping around for healthcare as if it were clothes or groceries. You'd get a system full of fraud and manipulation and profiteering (look at energy and water), with a lower overall level of efficiency (measured as good outcomes per money spent), and an enormous correlation between how rich you are and how well you get treated. This fetishization of choice is unhelpful. It's about provision.
Which hasn't worked. Private healthcare providers, meanwhile, give a great service. Which is a result of them having to provide a service to consumers. If eg Private Health Provider A began to kill people, or provide sub-standard levels of healthcare then it would soon go out of business. Not so the NHS which does both of these things with alarming frequency.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
It's Topping - best to just ignore his bullshit or ask him to provide the evidence to back it up...
Obviously we're trying to be polite on this forum but you are a fucking twat.
"The UK’s NHS performs worse than the average in the treatment of 8 out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years
It is the third poorest performer compared to the 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’).
It has consistently higher rates of death for babies at birth or just after (perinatal mortality), and in the month after birth (neonatal mortality): 7 in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries."
But then again on the bright side it "has the largest share of generic prescribing of all comparator countries, at 84 per cent in 2015 compared to an average of 50 per cent." Whatever the fuck that means.
I dislike the NHS because it is bad at what it does and it is bad at what it does compared with other healthcare systems.
Tosser.
Question is- why is this so?
Is it because of poor staff attitudes because patients can't take their custom elsewhere?
Or is it because as a nation we've always skimped a bit and tried to get away with that by pushing money into staff numbers rather than buildings and machines that might help staff work more efficiently?
Judging by recent experience it seems to be cultural. They could do better with what they have, but don't try very hard.
I don't know whether that is morale, leadership, lack of incentive, or what.
It would be great if they had top notch facilities everywhere but I fear that wouldn't fix the problem.
Comments
(I've always hoped that the Met line might re-commission Lord's station. When I was young I always wondered what the odd 'ruins' were, and then with the onset of the internet I found out. It'd be so handy!)
I worked on this campaign, so I can explain (I live in St Albans and am a local Green activist).
St Albans is essentially a London suburb - lots of commuters into the City, lots of nice green space, lots of big houses and fancy schools. Whilst it voted Lab in '97 at a parliamentary level, it has typically been Tory or LD. It's a lot of people who might be Tory for economic reasons, LD for social reasons, and specifically not Labour for class reasons.
This specific seat is the town centre seat - a higher percentage of graduates, relatively high income, whilst also having high turnover and younger voters. It is also one of the few places in Hertfordshire that voted Remain over Leave (I think by like 60 / 40). So the LDs won the parliamentary seat in '19 and have been really strong since.
The LDs and Cons have typically swapped control of the council on small margins and periods of NOC. Before '22 the council was LD led, with the LDs and Cons on an equal number of councillors and one Green (in this ward) and a few independents and Labour councillors. In '22 the boundaries changed, and an all up election was held (St A usually does elections in thirds every year, with one off year for county elections). In that election the Cons were wiped out to 4 or 5 elected councillors, Lab lost all their councillors and the Greens held their seat, as did one or two independents. The LDs took the rest, holding like 80% of the council.
At the last local election cycle the Green councillor was defending in this seat and had a LD challenger for the first time in a while since the Tories obviously couldn't win it (previously it was a three or even four way seat, with one year the Tories winning with only 26% of the vote, and we've had a local pact with the LDs that they wouldn't stand against us if we supported them leading the council in NOC scenarios). Our councillor won, proving that he could beat the LDs. The greens also won in the neighbouring seat, which is also the ward of the LD council leader (although it wasn't him who was displaced, as he's not up til next year). So two Green wins in very LD territory.
After the recent local elections a big issue turned up of tree felling - the local council said it was going to cut down 250 trees for health and safety reasons. Lots of local people didn't like this, and a pretty sizable number of people were willing to campaign on it. The local LDs, safe in their huge majority, essentially ignored it and said it was all words no action from Greens who don't know what running a council is like. Like Sheffield, this blew up a bit and became a story in the national cycle for a bit, with spots in the Times and radio interviews on LBC etc. A local member of neighbourhood who knows people, is involved in the allotments, volunteers with Greenpeace etc. wanted to run in the by election, so they did.
Then it was ground game, where we did a lot of work.
TL;DR - local issues and ground game.
Great to be in a Party with so many Policies I agree with
SKS Tories offers nothing for people like me
And the Lab candidate is Ginger.
I have placed £50 on the Tories to win Uxbridge.
https://www.telegraph.co.uk/tax/news/young-high-earners-emigration-uk-cost-living-income-tax/ (no paywall)
It’s a not-too-subtle dig at the need for the British government to sort things out, or risk an exodus of the qualified, the rich, and the ambitious.
On another subject, I am in the closing stages of 6 months of house renovation. I am running out of mugs suitable for giving to tradesmen - all the really appropriate ones have got lost or broken or left on a roof and filled full of mold. We're getting down to mugs which say 'For my Daddy on Father's Day' or 'Forever Friends' or some such. Lack of boring mugs has never been a problem in my life before - quite the reverse; the cupboard has been full to overflowing, and I am lamenting the careless ease with which I let go the mug advertising Wispa, the souvenir from South Uist, the boring grey one which no-one ever chose.
Let this be a salutary lesson for all of you.
Apart from living quite close, and always having lived in that area, my brother happens to work as a driver on the Bakerloo. Before you get your nose out of joint.
Not a serious environmental movement.
The reason is, he sees Sunak as completely dismantling everything Johnson.
https://news.sky.com/story/rishi-sunak-scraps-second-round-of-boris-johnsons-flagship-towns-fund-12901436
BTW have you visited every station in the "Greater TfL" contactless ticketing area? Out to places like Luton Airport, Reading, Gatwick, Hertford, etc. Like I have?
Joe Clarke is 221 not out at Trent Bridge for Notts v Warwickshire.
https://www.youtube.com/watch?v=XZG0VkJoQbc
Hence if you looked at the overall picture his results were terrible but if you just looked at the profile of his typical patient he was 50% better than everyone else on the list.
Strangely enough those lists stopped being published soon after they started.
I've never encountered anyone saying they're going private because the standardised mortality in the local Nuffield is so much lower (which it may well be, but partly because the privates generaly do more of the routine stuff).
You can walk into even the tiniest 7/11 in some backwoods non place and find a really decent selection of ice cold bottled craft beers, often excellent, sometimes superb
I had one just yesterday on my hike in Shenandoah
From Colorado
There is a nascent campaign to demolish it, which I would support - the motorway ruins the city in more ways than just pollution. And the layout of Glasgow is perfect for a publicly owned bus and tram system, and the streets wide enough for Dutch-style cycle infrastructure.
The ULEZ seems like the wrong intervention. Cheap though.
Most good hotels are really pricey. Even average ones costly. America is expensive. Then I found one which is cheap. REALLY cheap. AND it’s beautiful.
So I thought. Something is up. Why is it so cheap? A beautiful 1820s mansion designed by a protege of Jefferson? Turns out it was a lunatic asylum and a prison. And it really was. Doors are cell doors
Then I arrived here and found that the atmosphere was even creepier and weirder than I expected. And I sat down on the hotel terrace in the dusk and did some research and discovered this
Basically the whole place was run by a Nazi doctor who forcibly sterilised and lobotomised thousands of poor white hillbilly girls who were forced out of Shenandoah national park
It’s like staying in a SS laboratory complex. That’s why suites are £70 not £500
The last thing we - the patients - need is to go back to the brain-dead "the NHS is always right" that occurred during that travesty, when whistle-blowers were hounded out of town. And one of the people responsible becomes a loudmouth mayor.
Caught between two very different philosophies?
In the winter of 1999-2000, the NHS almost ground to a complete halt because of an outbreak of flu. Almost all non-emergency operations were cancelled, and the country at one point was left with just two intensive-care beds, with patients shuttled hundreds of miles in search of somewhere to stay.
The crisis was so severe it destroyed public faith in the NHS, and forced Tony Blair to launch a national plan to save it. A similar crisis was avoided last year only because the incidence of flu was unusually mild.
Ten years of on-and-off pain caused by the NHS; fixed privately.
What we want is more and better aggregate medical resource, distributed efficiently to where it's most needed, regardless of the personality or social power or bank balance of the patient. So the question is how to achieve this. I don't know. I'm not an 'NHS envy of the world' person but I do want to stick with 'free at the point of provision'. If we ever go the market route for Health, that would be grim indeed. Money buys you plenty of advantages in life (always has, always will). Let's not make a point of adding to the list.
But let's not forget that America also gave us Coors Light.
You don’t get that selection, so ubiquitously, anywhere else in the world
The NHS is a massive organisation, which employs a massive number of people. You will get people who do the wrong thing it, whether that be because they are wrong 'uns, ill-trained, uncaring, or just plain unlucky.
The same is true of any organisation. The key thing is for an organisation to detect when this is happening, and fix it - whether that be by more training, sacking negligent staff, or whatever.
At Stafford, for *years*, the leadership ignored it. The staff and the NHS cultists blamed the whistleblowers. Including the desecration of a whistleblower's mother's grave. And the Labour government gave them cover.
https://www.theguardian.com/society/2013/oct/27/julie-bailey-mid-staffordshire-nhs-whistleblower
@TonyJuniper
Dear @BBCNews could you please stop saying how pleased we all are with continuing dry, sunny & hot weather? Our rivers & wetlands are dying & wildlife fading away. We need RAIN. It is good. You can’t make the weather, but please stop saying global heating is a positive thing.
Last edited
10:42 PM · Jun 12, 2023"
https://twitter.com/TonyJuniper/status/1668373306003578880
..- -.- .-. .- .. -. ..
It is an NHS thing. Structurally it allows if not condones such behaviour and incidents because no one takes responsibility and no one is accountable so no one really cares. Not really, because the comebacks are few and far between.
I have in various instances been in and out of PALS (when it's open, which is not often) so many times it makes my head spin and, like many service providers you have to be prepared to pursue your claim in the face of opposition and NHS sainthood.
The NHS system produces people who work for it who don't really care and that's the problem.
“We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% (95% CI 0·22–0·55; p=0·0016) or 0·29 (95% CI 0·09–0·49; p=0·0041) deaths per 100 000 population in the following year. This finding was robust to matching on background characteristics, adjusting for possible confounding factors, and measurement error in our dataset. Changes to for-profit outsourcing since 2014 were associated with an additional 557 (95% CI 153–961) treatable deaths across the 173 CCGs.”
The reality however is that it fares very badly indeed vs its peers and that is down to its organisation and structure.
Here’s another case at a private hospital: https://www.standard.co.uk/news/uk/spire-healthcare-surgeon-operations-patient-recall-a4344146.html
\\\https://www.youtube.com/watch?v=zHamgwlQ1yo
Made famous by the late, great Dr. Ralph Stanley, from the mountains of southwest VA.; the movie version by the "Soggy Mountain Boy" is a true tribute to Stanley and his band, the Clinch Mountain Boys".
https://en.wikipedia.org/wiki/Ralph_Stanley
Who was perhaps the most prominent member of the Primitive Bapist Universalist Church, a very small fundamentalist denomination notable for belief that there is no Hell for anyone after death, because Christ attoined for ALL, and "it's hell enough on earth.
https://en.wikipedia.org/wiki/Primitive_Baptist_Universalist
"The UK’s NHS performs worse than the average in the treatment of 8 out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years
It is the third poorest performer compared to the 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’).
It has consistently higher rates of death for babies at birth or just after (perinatal mortality), and in the month after birth (neonatal mortality): 7 in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries."
But then again on the bright side it "has the largest share of generic prescribing of all comparator countries, at 84 per cent in 2015 compared to an average of 50 per cent." Whatever the fuck that means.
https://www.kingsfund.org.uk/press/press-releases/nhs-receives-mixed-scorecard-major-analysis-international-health-systems
I dislike the NHS because it is bad at what it does and it is bad at what it does compared with other healthcare systems.
Tosser.
But, I do agree with your substantive point that the US is right up there in the craft beer stakes.
Is it because of poor staff attitudes because patients can't take their custom elsewhere?
Or is it because as a nation we've always skimped a bit and tried to get away with that by pushing money into staff numbers rather than buildings and machines that might help staff work more efficiently?
I'm not obsessed with the present NHS model, happy to switch it for one of the decent European ones, of which there are many. But they do also cost a bit more to deliver the better services some of them deliver.
(I'm currently battling the NHS on behalf of my parents, so I'm far from in love with it - my mother has a nonspecific and as yet undiagnosed condition and has been passed from specialist to specialist, ward to ward and no one cares - or perhaps no one has the time to care. Presently, the GP or the hospital have manged to lose/not send the discharge letter from her latest stay, which had instructions for further investigations which, as of yet, have not happened)
Does it matter if your granny isn't given a bedpan or water or her drugs for a couple of days? Not really. What's granny going to do and you're not there to shout about it. So it happens. Often. And no I don't have the stats but ask 10 of your friends and many of them will have had such experiences.
Dr Jennifer Dixon, Chief Executive of the Health Foundation said:
"Compared to the other 18 countries the UK has middling funding and middling performance overall."
Paul Johnson, Director of the Institute for Fiscal Studies said:
"The truth about the NHS is that by international standards it is a perfectly ordinary healthcare system, providing average levels of care for a middling level of cost."
I don't know whether that is morale, leadership, lack of incentive, or what.
It would be great if they had top notch facilities everywhere but I fear that wouldn't fix the problem.