NHS "Fat Cats" ?
Discussion
I work in the NHS and get so fed up of hearing it described as inefficient by people who have no concept what the delivery of healthcare involves. For all those posting about how bad the NHS is and how inefficient - educate yourselves and stop repeating the same soundbites you read in the daily mail.
How people with no involvement in healthcare can make any assessment of how much the NHS 'should' cost is beyond me. They have no knowledge of simple costs such as that of an MRI scan, a bed in an ITU, a full blood count, let alone that of drugs, surgical procedures, staffing, estates etc. For many on here the NHS budget of 130billion is too much simply because its a big number!
Why not read something other than the fiction of the daily mail.........
http://www.independent.co.uk/news/uk/uks-healthcar...
Unfortunately for many here, the facts simply don't tally with the anti NHS dogma they like to propagate.
How people with no involvement in healthcare can make any assessment of how much the NHS 'should' cost is beyond me. They have no knowledge of simple costs such as that of an MRI scan, a bed in an ITU, a full blood count, let alone that of drugs, surgical procedures, staffing, estates etc. For many on here the NHS budget of 130billion is too much simply because its a big number!
Why not read something other than the fiction of the daily mail.........
http://www.independent.co.uk/news/uk/uks-healthcar...
Unfortunately for many here, the facts simply don't tally with the anti NHS dogma they like to propagate.
Digga said:
t's not only this. There is a tendency within the public sector to build empires, not least because manager's pay may be derived as a function of the headcount of the staff for which said manager is 'responsible'. Then, with OPM, you have budget grab dynamics - budgets, from the POV of a manager, are always sticky-up. A lot of this tends toward inefficiency on a grand scale, which I have witnessed first hand; front line staff may be worked very hard, whilst surrounded by a plethora of busy-doing-nothing, admin and overhead.
from what i gather from a mates wife and my step mother this is spot on. in every single contact i have had with nhs front line staff the service has been exemplary . the management are a completely different kettle of fish. the simple act of how many staff to have on shifts based on historical busy/quiet times was beyond them after the refurb of my local hospital ,really felt for those on the front desk in a+e who knew the problem ,and solution ,yet were not listened to by those in the position to change the situation. utter madness.I for one don't care how much the fat cats get paid. I couldn't care less whether they get 500k or a million.. What I do care about is that there should be some consistency in the salary reviews, awarding a top exec a 10% pay rise (or whatever the DM was quoting) seems a little strange/wrong/questionable when front line staff are battling for a lot less.
As a previous poster alluded to i'm sure there are some remarkable efficiencies at work within the NHS, but the amount of things I get told about the NHS from people who work alongside or for them always has a consistent theme - that some departments have more money than sense and spend so accordingly.
As a previous poster alluded to i'm sure there are some remarkable efficiencies at work within the NHS, but the amount of things I get told about the NHS from people who work alongside or for them always has a consistent theme - that some departments have more money than sense and spend so accordingly.
wc98 said:
from what i gather from a mates wife and my step mother this is spot on. in every single contact i have had with nhs front line staff the service has been exemplary . the management are a completely different kettle of fish. the simple act of how many staff to have on shifts based on historical busy/quiet times was beyond them after the refurb of my local hospital ,really felt for those on the front desk in a+e who knew the problem ,and solution ,yet were not listened to by those in the position to change the situation. utter madness.
this.the front line NHS staff do on the whole a superb job DESPITE the inept management.
Let's be honest, would any of us want to be working in a casualty department on a Friday night? yet we expect them to (and get abused because of it).
Scuffers said:
this.
the front line NHS staff do on the whole a superb job DESPITE the inept management.
Let's be honest, would any of us want to be working in a casualty department on a Friday night? yet we expect them to (and get abused because of it).
One thing that I will say is that whilst the frontline staff are, as a rule, fantastic are care delivery there are, like most of us, there are 'non care giving' parts of their job which they are not so good at which has a knock on impact. Simple sounding things like a midwife putting scissors into the wrong waste receptacle can cost the NHS hundreds of pounds in terms of man and physical knock on costs. the front line NHS staff do on the whole a superb job DESPITE the inept management.
Let's be honest, would any of us want to be working in a casualty department on a Friday night? yet we expect them to (and get abused because of it).
As another poster alluded to though it isn't all just a simple question of "Well, let's do this then" in some areas though due to constraints imposed by various third parties, including PFI's and over zealous people in certain departments whose attitude is 'if I don't understand everything about it (even if I never will) I'm not going to let it happen.'
tdog7 said:
I work in the NHS and get so fed up of hearing it described as inefficient by people who have no concept what the delivery of healthcare involves. For all those posting about how bad the NHS is and how inefficient - educate yourselves and stop repeating the same soundbites you read in the daily mail.
How people with no involvement in healthcare can make any assessment of how much the NHS 'should' cost is beyond me. They have no knowledge of simple costs such as that of an MRI scan, a bed in an ITU, a full blood count, let alone that of drugs, surgical procedures, staffing, estates etc. For many on here the NHS budget of 130billion is too much simply because its a big number!
Why not read something other than the fiction of the daily mail.........
http://www.independent.co.uk/news/uk/uks-healthcar...
Unfortunately for many here, the facts simply don't tally with the anti NHS dogma they like to propagate.
Given the NHS has been identified as one of, if not the, largest purchasers of drugs in the world in budget terms, why are they so sHow people with no involvement in healthcare can make any assessment of how much the NHS 'should' cost is beyond me. They have no knowledge of simple costs such as that of an MRI scan, a bed in an ITU, a full blood count, let alone that of drugs, surgical procedures, staffing, estates etc. For many on here the NHS budget of 130billion is too much simply because its a big number!
Why not read something other than the fiction of the daily mail.........
http://www.independent.co.uk/news/uk/uks-healthcar...
Unfortunately for many here, the facts simply don't tally with the anti NHS dogma they like to propagate.
t at extracting discounts from Big Pharma?hidetheelephants said:
Given the NHS has been identified as one of, if not the, largest purchasers of drugs in the world in budget terms, why are they so st at extracting discounts from Big Pharma?
A few years ago a friend was going out with a VP for Pharma Corp. She and I spoke about the cost of things and so on and apparently the US is basically underwriting the cost of the drugs on the market and the NHS, etc are getting much cheaper deals. How true I don't know but she had no reason to lie.t at extracting discounts from Big Pharma?vonuber said:
98elise said:
That said for the money it recieves we get a piss poor service so something is not working.
I had a brain tumour removed in 2011, the service from the NHS was exemplary and I have no complaints whatsoever. They were utterly brilliant form start to finish, and I have had excellent follow up care ever since.My daughter was born in 3 weeks ago, again the NHS was absolutely brilliant. We even have a prompt follow up appointment for a scan on her hip. The post birth service with the midwives and home visits has also been very good.
I for one have been very happy with the NHS.
This has little or nothing to do with the tractor production commissar classes - most of those are bands 7 to 8c under the Agenda for Change contracts
there are basically three sets of contracts in the NHS
Agenda for change which covers everyone except
(employed) Doctors and Dentists
Directors
(GP partners and dentists in simialr set ups is a seperate tray of tins of worms)
AFC and Docs and Dents is standard contracts, standardisaed pay rates etc
Directors is a free for all ' to attract the best talent'
there are basically three sets of contracts in the NHS
Agenda for change which covers everyone except
(employed) Doctors and Dentists
Directors
(GP partners and dentists in simialr set ups is a seperate tray of tins of worms)
AFC and Docs and Dents is standard contracts, standardisaed pay rates etc
Directors is a free for all ' to attract the best talent'
tdog7 said:
I work in the NHS and get so fed up of hearing it described as inefficient by people who have no concept what the delivery of healthcare involves.
Every politician and reckoning man with a pint thinks the health service could deliver better value yet none have actually managed yet.Although, as the US shows, the only thing worse than a public health service is to not have one. Never an easy answer is there?
audidoody said:
My elderly mother-in-law went into Northampton General with a throat ailment. Came out in a pine box after dying in agony from CDiff caught from the filthy conditions there. How much was the manager of that hell-hole being paid?
The dirty conditions are not that uncommon unfortunately. Basic management failure at all levels.tdog7 said:
... For many on here the NHS budget of 130billion is too much simply because its a big number!...
Personally I think it's too much simply because we can't afford it. Not limiting the NHS budget is the wrong way to go about it IMO. It sets false expectations with its "customers" and potentially propagates poor behaviour with the people running it. It should be subject to cuts like any other service and it's budget should be set according to what the country can afford.
As a nation we have got to start being realistic about what can and cannot be provided. A line needs to be drawn that is consistently applied throughout the country. And treatment above wherever that line is set should only be available to those who can self fund it.
I have absolute respect for front line staff - my sister and many friends are nurses. When our first child was born, the service went above and beyond (too much so imo). But there needs to be a massive shift in the services that are provided, the approach to funding and the way it's treated like a political football.
V8 Fettler said:
audidoody said:
My elderly mother-in-law went into Northampton General with a throat ailment. Came out in a pine box after dying in agony from CDiff caught from the filthy conditions there. How much was the manager of that hell-hole being paid?
The dirty conditions are not that uncommon unfortunately. Basic management failure at all levels.- A 'semi-emergency' (the surgeons notes) operation in France on their NHS.
- Follow up op to remove initial metalwork in UK at 3 months.
- Final op to remove metal plates & screws at 6 months.
- Numerous intermediate appointments for x-rays, scans and physio.
- French NHS superb. Biggest point of note was way wards were run. I was in for 3 nights and every evening when my mates (who were still hooning down Alps) came to visit, they were envious of the number of nurses hovering about the place. They policed and cleaned the wards and genuinely looked after patients - it was a vocation.
- UK wards were a bit grubbier in places - some cleaning staff just did not give a stuff - but operating and front-line staff were superb. Consultant was first-rate and mad keen not only to see his part of the operation through, but also to get me back on a mountain bike.
- UK physio and remedial staff were superb.
- There are a lot of 'hangers-on' in the NHS; clipboard, jobsworth, do bugger all wkers. Lots. They intermingle with the busy staff (who must have the patience of saints to tolerate them) and even hinder them with idle chit chat and lacklustre back-up.
- Never knowingly saw what I would term management on the floor.
Murph7355 said:
Not limiting the NHS budget is the wrong way to go about it IMO. It sets false expectations with its "customers" and potentially propagates poor behaviour with the people running it. It should be subject to cuts like any other service and it's budget should be set according to what the country can afford.
One of the (few) benefits to funding reductions is it really creates a cultural focus on what is waste and non-essential. The same happens when private organisations have to get lean. NHS cuts are considered political suicide. The nation is getting older, fatter and less healthy. How much more money can we continue to put in it?
I have physical evidence of a project manager at a London CCG putting in invoices of £10,000/week towards the end of their contract.
On review it was found out that they had claimed pay for working on Christmas, Boxing, New Years day and all the weekends in the 3 months leading to the review. They even claimed to be working over a 100hrs per week to maximise their earnings.
Well done to the daily mail for exposing this but I believe they have uncovered less than half the waste in the administrative side of the NHS. The biggest fraud is perpetuated by senior managers who bring in expensive contractors (usually a person the senior manager knows) without going through a selection process and then sign off ridiculous invoices like described above.
On review it was found out that they had claimed pay for working on Christmas, Boxing, New Years day and all the weekends in the 3 months leading to the review. They even claimed to be working over a 100hrs per week to maximise their earnings.
Well done to the daily mail for exposing this but I believe they have uncovered less than half the waste in the administrative side of the NHS. The biggest fraud is perpetuated by senior managers who bring in expensive contractors (usually a person the senior manager knows) without going through a selection process and then sign off ridiculous invoices like described above.
Eclassy said:
I have physical evidence of a project manager at a London CCG putting in invoices of £10,000/week towards the end of their contract.
On review it was found out that they had claimed pay for working on Christmas, Boxing, New Years day and all the weekends in the 3 months leading to the review. They even claimed to be working over a 100hrs per week to maximise their earnings.
Well done to the daily mail for exposing this but I believe they have uncovered less than half the waste in the administrative side of the NHS. The biggest fraud is perpetuated by senior managers who bring in expensive contractors (usually a person the senior manager knows) without going through a selection process and then sign off ridiculous invoices like described above.
Are these senior managers regarded as holding public office? There was a case recently where a paramedic was regarded as not holding public office.On review it was found out that they had claimed pay for working on Christmas, Boxing, New Years day and all the weekends in the 3 months leading to the review. They even claimed to be working over a 100hrs per week to maximise their earnings.
Well done to the daily mail for exposing this but I believe they have uncovered less than half the waste in the administrative side of the NHS. The biggest fraud is perpetuated by senior managers who bring in expensive contractors (usually a person the senior manager knows) without going through a selection process and then sign off ridiculous invoices like described above.
The major issue with the NHS in my opinion is that nobody is actually in charge of it
I've worked in multiple major organisations of a broadly similar budget and reach and pretty much all of them hav a similar structure:
Man at the top - CEO etc
Board of executives, each one responsible for a particular area of the business
Cascading down from this another level of senior management responsible for operations of the specific business areas
Below this varying levels of middle managers implementing the policy from above
You then get to the Team Leads / Supervisors/ Worker Bee level who actually deliver the work
NHS is a mess of multiple organisations, multiple CEOs / Bosses / Managers (does each and every hospital need a CEO, Finance Director, HR Director etc)
Can anyone tell me who is in charge of which areas? I know of no other (efficient) large organisation that is structured like this:
http://insightpublicaffairs.com/wp-content/uploads...
Most private companies of equivalent size have been busy simplifying structures and removing layers of management during the recession, the answer to most questions in the NHS seems to be to move responsibilities around again, and add more complexity.
To those who say that "outsiders cannot say that there is inefficiency in the NHS as they do not know the complexities of care delivery" I say that I was recently treated (very effectively) by the NHS locally. My treatment / outpatient appointments were seamlessly arranged in a variety of locations within the 3 hospitals in the same town, however each hospital was a separate Trust, so the whole CEO, Management Board overhead etc for each one.
On another level I had to use a form to record a specific activity during stays in each hospital. The form was different in every one, printed by a separate printing company with a slightly different layout for the same information
You do not need to be a clinical expert to spot waste in the NHS, its all around you if you have any level of common sense. Maybe NHS staff are too close in to see it.
I had a discussion with a couple of friends who are in the NHS - a GP (and why would a GP wholly working within the NHS be running a practice as a separate business and having to worry about arranging building work on the practice office, tax issues etc) and a nurse.
The nurse could not see that simplifying the whole management structure would free up billions of pounds that could be spend on frontline care. She just blamed "The Management"
The GP admitted that she could not identify who she actually worked for within the NHS after all the changes.
Its this complexity that kills the NHS, nobody is identified as being in charge, nobody is responsible for things that go wrong (Bosses of RBS and BP were both fired when things went majorly wrong within the business, its admitted that North Stafford Hospital issues actually killed people, but nobody is brought to book)
It prevents the type of central efficiency drives that private businesses take for granted, and it prevents the NHS benefiting from the potentially enormous economies of scale that it could deploy in procurement etc
I've worked in multiple major organisations of a broadly similar budget and reach and pretty much all of them hav a similar structure:
Man at the top - CEO etc
Board of executives, each one responsible for a particular area of the business
Cascading down from this another level of senior management responsible for operations of the specific business areas
Below this varying levels of middle managers implementing the policy from above
You then get to the Team Leads / Supervisors/ Worker Bee level who actually deliver the work
NHS is a mess of multiple organisations, multiple CEOs / Bosses / Managers (does each and every hospital need a CEO, Finance Director, HR Director etc)
Can anyone tell me who is in charge of which areas? I know of no other (efficient) large organisation that is structured like this:
http://insightpublicaffairs.com/wp-content/uploads...
Most private companies of equivalent size have been busy simplifying structures and removing layers of management during the recession, the answer to most questions in the NHS seems to be to move responsibilities around again, and add more complexity.
To those who say that "outsiders cannot say that there is inefficiency in the NHS as they do not know the complexities of care delivery" I say that I was recently treated (very effectively) by the NHS locally. My treatment / outpatient appointments were seamlessly arranged in a variety of locations within the 3 hospitals in the same town, however each hospital was a separate Trust, so the whole CEO, Management Board overhead etc for each one.
On another level I had to use a form to record a specific activity during stays in each hospital. The form was different in every one, printed by a separate printing company with a slightly different layout for the same information
You do not need to be a clinical expert to spot waste in the NHS, its all around you if you have any level of common sense. Maybe NHS staff are too close in to see it.
I had a discussion with a couple of friends who are in the NHS - a GP (and why would a GP wholly working within the NHS be running a practice as a separate business and having to worry about arranging building work on the practice office, tax issues etc) and a nurse.
The nurse could not see that simplifying the whole management structure would free up billions of pounds that could be spend on frontline care. She just blamed "The Management"
The GP admitted that she could not identify who she actually worked for within the NHS after all the changes.
Its this complexity that kills the NHS, nobody is identified as being in charge, nobody is responsible for things that go wrong (Bosses of RBS and BP were both fired when things went majorly wrong within the business, its admitted that North Stafford Hospital issues actually killed people, but nobody is brought to book)
It prevents the type of central efficiency drives that private businesses take for granted, and it prevents the NHS benefiting from the potentially enormous economies of scale that it could deploy in procurement etc
tdog7 said:
I work in the NHS and get so fed up of hearing it described as inefficient by people who have no concept what the delivery of healthcare involves. For all those posting about how bad the NHS is and how inefficient - educate yourselves and stop repeating the same soundbites you read in the daily mail.
How people with no involvement in healthcare can make any assessment of how much the NHS 'should' cost is beyond me. They have no knowledge of simple costs such as that of an MRI scan, a bed in an ITU, a full blood count, let alone that of drugs, surgical procedures, staffing, estates etc. For many on here the NHS budget of 130billion is too much simply because its a big number!
Why not read something other than the fiction of the daily mail.........
http://www.independent.co.uk/news/uk/uks-healthcar...
Unfortunately for many here, the facts simply don't tally with the anti NHS dogma they like to propagate.
http://www.dailymail.co.uk/debate/article-3048058/It-s-wrong-Fat-cats-milk-NHS-doctors-like-turn-away-sick-save-cash-writes-MAX-PEMBERTON.htmlHow people with no involvement in healthcare can make any assessment of how much the NHS 'should' cost is beyond me. They have no knowledge of simple costs such as that of an MRI scan, a bed in an ITU, a full blood count, let alone that of drugs, surgical procedures, staffing, estates etc. For many on here the NHS budget of 130billion is too much simply because its a big number!
Why not read something other than the fiction of the daily mail.........
http://www.independent.co.uk/news/uk/uks-healthcar...
Unfortunately for many here, the facts simply don't tally with the anti NHS dogma they like to propagate.
Sounds about right to me but what does he know? He's only a doctor and it must be fiction as its in the daily mail...
Gassing Station | News, Politics & Economics | Top of Page | What's New | My Stuff