NHS reforms..a mess?

[mobertol]

Even "civilised" countries like the USA do not offer it's citizens what the UK (and much of Europe) has. As highlighted by BG, if you don't have the wherewithall to pay in many countries -you keep your bad back, don't get your cancer treated and if you're a woman giving birth and don't have health insurance in America you get sent back out into the street!

If, as has been written on the Olympic Farrago thread, some people are worried that the Olympics will be seen by some as a health tourism opportunity, then from the outside looking in, the NHS is seen very differently to the way it's often portrayed here -I suppose it's all relative. If you are used to a 3 hour drive to get to a wooden hut - a local fully equipped hospital looks pretty damn good.

[maxthecollie]

Bring back the Matrons and get rid of the beaurocrats and hangers on.

[ToffeeGuy]

Same old Tories, can't be trusted with the NHS.

[Margaret Pilkington]

Max, they brought back the matrons, but it was just another layer of management.
The Salmon Report in 1966 changed the management structure of Nursing.
One Matron, who would oversee the whole hospital was replaced by Nursing Officers (one for each specialty) So what had been done by one woman was now going to be done by many(a lot of them career nursing men - not that interested in looking after patients, but more interested in climbing the career ladder)........and the management pyramid has continued to expand from there.......all of it costing more and not much of it benefitting the patient.

Any nurse who transgressed(broke a thermometer, ran in a corridor) was summoned by Matron for a dressing down.
Now, I want to tell you that this was before my time as a nurse, but a very good friend of mine became a cadet, then a nurse, while the Matron system was still in operation.
She remembers being summoned to Matron Knavesy for breaking a large Winchester bottle of cleaning fluid - her pay was docked by one shilling.
Matron had the power in those days.
The Modern Matrons were just a sop to public opinion....the public thought that bringing back the matron would cure the ills in the NHS.....no such luck. Giving someone a fancy title doesn't make things better if you give them little power to go with the title.

[Boeing Guy]

Originally Posted by ToffeeGuy

Same old Tories, can't be trusted with the NHS.

And what did labour do..... PFI was a disaster. We will be paying for it for the next 50 years at least.
Take politics out of this and look at the real world, rather than your rose tinted socialist worker

[Boeing Guy]

Originally Posted by Margaret Pilkington

The Salmon Report in 1966 changed the management structure of Nursing.
One Matron, who would oversee the whole hospital was replaced by Nursing Officers (one for each specialty) ]

And which government was that then.....
Harold Wilson, Labour....
they are all the same

[Margaret Pilkington]

Originally Posted by ToffeeGuy

Same old Tories, can't be trusted with the NHS.

Don't feel so smug.
And Labour couldn't either. They saddled the communities and NHS trusts with the PFI. Building hospitals with private money and then charging the trusts an indeterminate amount(for an indeterminate period) to lease them back(at great profit to the private company).......making the trusts buy services from the private company at exorbitant costs, so that something like changing a light bulb costs £400.......£400 which could have been spent on life saving drugs or treatment for a patient(maybe your mother or your father).

[Gordon Booth]

Originally Posted by Margaret Pilkington

making the trusts buy services from the private company at exorbitant costs, so that something like changing a light bulb costs £400.......£400 which could have been spent on life saving drugs or treatment for a patient(maybe your mother or your father).

Margaret, is that an actual charge? If so do you know any others?
I was going to say 'I don't believe it' but I can.What a scandal!
Mind you if HBC can cost mending an allotment tap at £500 it seems quite reasonable.

[cashman]

Originally Posted by ToffeeGuy

Same old Tories, can't be trusted with the NHS.

Same old Toffee Guy,I wouldn't trust you to Boil N Egg.

[ToffeeGuy]

Originally Posted by Boeing Guy

And what did labour do..... PFI was a disaster. We will be paying for it for the next 50 years at least.
Take politics out of this and look at the real world, rather than your rose tinted socialist worker

In 2009:-

The average wait for a hip operation has come down to 12 weeks from 30 in two years.


The wait from being sent to a specialist by a GP and treatment was just 8.6 weeks.


And for a cataract operations it was 10 weeks, having come down from 20 in two years.


In 2009 :-


Nick Bosanquet, Professor of Health Policy at Imperial College, London acknowledged spending billions had reduced waiting lists.


Touche!

[Neil]

Originally Posted by Gordon Booth

Mind you if HBC can cost mending an allotment tap at £500 it seems quite reasonable.

Do you know what the actual work done was or are you just quoting the one line description from the accounts sheet?

[Boeing Guy]

BBC Sept 2011

Paying off the "NHS mortgage" is putting so much pressure on the system in England that the future of some hospitals is at risk, ministers say.

The government said 22 trusts - running 60 units - are facing difficulties because of the cost of paying for privately-funded building projects.

The group represents nearly a fifth of the 100-plus PFI schemes in the NHS.

Problems are being encountered because, for some trusts, repayments account for up to a fifth of their budget.

Unison

Reason 3: PFI costs more
PFI schemes cost much more than conventionally funded projects. The private sector borrows at higher rates than the public sector since governments can borrow at much lower rates. Audit Scotland have calculated these costs as adding £0.2 - £0.3 million each year for every £10 million invested. They have high set up costs, due to lengthy negotiations involving expensive city lawyers and consultants employed by both sides. The first 15 NHS trust hospitals spent £45 million on advisers an average of 4% of the capital value. The private sector demands high returns and despite very low risks, profits from PFI are extremely high.
There is a growing body of evidence that PFI projects escalate both in scale and cost. These are not simple cases of costs going up for a project but reflect the very nature of PFI itself. The higher costs inevitably lead to an affordability gap for the procuring authority that is often met by reductions in services and capacity, subsidies from other parts of public authority budgets and pressures on labour costs. A recent article in the British Medical Journal found that there were 20% cuts in staffing levels in PFI hospitals.

Reason 4: PFI profits from people
UNISON has conducted research into the impact of contracting out in local government on the terms and conditions of the workforce. UNISON's survey found evidence of a two-tier workforce, something commented on by both the Treasury and Health committees of the House of commons.
Over 90% of those contacted said pay levels for new employees were worse that for transferred staff.
1 in 5 of contracts showed a difference in the standard working week
Pensions are a high value item for employees and a high cost item for contractors and public authorities.
Guidance from government means that successful contractors are obliged to offer a comparable pension scheme to transferred employees. Our research could not find a single comparable scheme open to new employees. There was either no scheme or else it was inferior and often the contractor made no contribution whatever.
There is inevitably a gender impact with women increasingly bearing the brunt of these new privatisations, just as they did under CCT and market testing. PFI contracts are at least 25 years long. As the first tier gradually disappears and only those staff on private sector terms and conditions are left, there will be a whole class of women workers providing public services who will have no occupational pensions and who will be working on inferior terms and conditions.

Reason 5: PFI goes wrong
There have been many claims that the private sector is more efficient than the public sector but there is no evidence offered to support this. Now that PFI schemes are coming on stream there is growing evidence that they are not producing the anticipated improvements in delivery to time or cost nor are they meeting the quality standards expected. After all, many of the same companies that were involved in pre-PFI cost and time overruns are also building PFI schemes.

Reason 6: PFI does not give 'value for money'
For many PFI projects, it is only the transferred risks that make the project value for money. Research for UNISON by Professor Allyson Pollock, looking at schools and hospitals, shows that the calculations of risk are arbitrary and unreliable. The National Audit Office has called the value for money calculation "pseudo-scientific mumbo jumbo where the financial modelling takes over from thinking".

BBC News November 2011

The committee said paying off a PFI debt of £1bn could cost taxpayers the same as paying off a direct government debt of £1.7bn.

The websites:
BBC News - Hospitals 'struggling with NHS mortgage repayments'

UNISON Private Finance Initiative (PFI) | the public service union

BBC News - Chancellor George Osborne set to 'reassess' PFI

Sorry to paste and copy, I know that's our dog stabbers modus operandi.

Yes PFI was introduced by the John Major Conservative Government, but Gordon ran with it and made it his own.

your move

[Boeing Guy]

just a thought, Unison are a supporter of the Labour party, now why would they say anything against them

[ToffeeGuy]

PFI? How else is a government expected to find the money for new hospitals when most people would rather have a nice holiday or buy a new car instead of stumping up a bit more tax.

[Boeing Guy]

Speak for yourself.
Maybe if a government made taxation fairer for all, say pay nothing under £10,000. Then everyone pays 25%. No loop holes. Perhaps you would get more raised.
Then again fair means those more well off must get squeezed.