J Hunt and S Hawking - how do we know...
Discussion
TooMany2cvs said:
That line is already drawn, regularly, by NICE.
We can't afford where the line seems to be. A solution is to move the line back a bit.TooMany2cvs said:
Elective plastic surgery - even boobjobs - can certainly come under preventative, especially when you consider mental health.
Isn't it amazing how we all managed to stay sane before boobjobs were available on the NHS?sidicks said:
[I've criticised .......
to accept that this inevitable means their pension schemes are also unsustainable and hence they will need to be moved to a DC scheme in the near future.
Then the true costs of employing workers could be more visible and we have more money available to provide NHS services, not to fund 'excessive' NHS pensions!
You manage to make one suggestion, you may not have noticed that retention of good doctors has hit critical, your solution of the beatings will continue until moral improves, gives us all good reason to question your credibilityto accept that this inevitable means their pension schemes are also unsustainable and hence they will need to be moved to a DC scheme in the near future.
Then the true costs of employing workers could be more visible and we have more money available to provide NHS services, not to fund 'excessive' NHS pensions!
Dixy said:
You manage to make one suggestion, you may not have noticed that retention of good doctors has hit critical, your solution of the beatings will continue until moral improves, gives us all good reason to question your credibility
What a stupid comment. Feel free to challenge my suggestion, but don't try and pretend I've said something entirely different to what I've actually said. Do you believe that massive increases in spending are the only way forward for the NHS?It seems my suggestion appears reasonable to a few others on here, who share broadly similar opinions.
Rovinghawk said:
TooMany2cvs said:
That line is already drawn, regularly, by NICE.
We can't afford where the line seems to be. A solution is to move the line back a bit.Rovinghawk said:
TooMany2cvs said:
Elective plastic surgery - even boobjobs - can certainly come under preventative, especially when you consider mental health.
Isn't it amazing how we all managed to stay sane before boobjobs were available on the NHS?http://www.nhs.uk/Conditions/cosmetic-treatments-g...
Even the Daily Brownshirt, in full-froth, can only come up with "up to £50m" - that's 0.05% of the annual NHS budget... and then they go on to admit that includes cancer reconstructions...
http://www.dailymail.co.uk/news/article-2681287/NH...
TooMany2cvs said:
Rovinghawk said:
We can't afford where the line seems to be. A solution is to move the line back a bit.
Can't we? You say that like it's a certainty. I don't think it is. Further, apparently the NHS is 'in crisis' meaning that a significant increase in spending is required. The issues that have led to the current situation (i.e. despite massive increases in spending in real terms, the health service is still significantly underfunded) are not going away and are only going to increase.
If we don't reduce the services that the NHS provides, where is the money going to come from to provide the increased spending that is apparently necessary. How can that continue to increase over time?
sidicks said:
TooMany2cvs said:
Rovinghawk said:
We can't afford where the line seems to be. A solution is to move the line back a bit.
Can't we? You say that like it's a certainty. I don't think it is. TooMany2cvs said:
And halving the NHS budget is the right solution to that,
Strawman nonsense. No-one has suggested any such thing.TooMany2cvs said:
rather than trimming elsewhere - or increasing income...?
Which leads to the same question raised on numerous occasions already - which public services are currently overfunded and can therefore be 'trimmed' to subsidise the NHS?How much extra income are you proposing to create and where from?
How sustainable is this, given that the key factors that have got us into the current situation are likely to continue hereafter?
sidicks said:
What a stupid comment. Feel free to challenge my suggestion, but don't try and pretend I've said something entirely different to what I've actually said. Do you believe that massive increases in spending are the only way forward for the NHS?
It seems my suggestion appears reasonable to a few others on here, who share broadly similar opinions.
As usual you start by being offensive, in what way does your suggestion not reduce the reward for work done. Then you go on to ask a totally unfounded question that I have demonstrated many times I do not believe in.It seems my suggestion appears reasonable to a few others on here, who share broadly similar opinions.
Perhaps you would like to make another constructive suggestion as to how the current unsustainable situation can be rescued.
Dixy said:
As usual you start by being offensive,
You started by blatantly misrepresenting what I said, with an added dose of emotional rhetoric for good measure. Thus your comment was stupid, as I'd said nothing like what you'd claimed.Dixy said:
in what way does your suggestion not reduce the reward for work done.
So you're failing to acknowledge that, over the last 10-20 years, increasing longevity massively increased the reward for work done? Is it any wonder that some people suggest that the public sector are seemingly oblivious to economics?The private sector recognised some time ago that the cost of these schemes were rising significantly to a multiple of their original levels and acted accordingly.
Dixy said:
Then you go on to ask a totally unfounded question that I have demonstrated many times I do not believe in.
Perhaps you would like to make another constructive suggestion as to how the current unsustainable situation can be rescued.
I have made what I (and a few others) believe to be a sensible suggestion. You've not explained why this isn't valid nor explained what your alternative solution is. In that case, I'm not sure what you are trying to add to the discussion?Perhaps you would like to make another constructive suggestion as to how the current unsustainable situation can be rescued.
Edited by sidicks on Wednesday 30th August 14:26
sidicks said:
TooMany2cvs said:
And halving the NHS budget is the right solution to that,
Strawman nonsense. No-one has suggested any such thing.sidicks said:
TooMany2cvs said:
rather than trimming elsewhere - or increasing income...?
Which leads to the same question raised on numerous occasions already - which public services are currently overfunded and can therefore be 'trimmed' to subsidise the NHS?How much extra income are you proposing to create and where from?
How sustainable is this, given that the key factors that have got us into the current situation are likely to continue hereafter?
TooMany2cvs said:
OK, so raising the £50bn deficit is an irrelevant number.
No, the fact there is a deficit is entirely relevant when people are trying to justify what is affordable or not!TooMany2cvs said:
How much are you suggesting cutting by? And, if the deficit is your intent, what are you going to do to cover the rest?
I've not suggested cutting spending on the NHS at all. Please read what I've actually said.TooMany2cvs said:
Seems to me like you've already decided that the NHS is your target, no matter what the facts and reality.
The thread is about the NHS.The claim is that the NHS needs significant extra funding, which will increase over time.
We already have a significant deficit.
I think it is you that is avoiding the 'facts and reality'!
TooMany2cvs said:
And halving the NHS budget is the right solution to that, rather than trimming elsewhere - or increasing income...?
The challenge is that every self interest group comes out of the woodwork and precludes savings in any area (child benefit; student fees; self employed NI; etc etc). I think one of the Scandiwegian countries, in acknowledging this, just said to lop xx% off everything and let each department figure out how. It's a good ploy IMO.
Another typical response is "it's only 0.05% of budgets so why bother?" . There is no single golden bullet IMO. If there was, a political party would have latched onto it by now.
I would say we need to cut a good 15% of our expenditure at least to see us on the right path. If the NHS is a third of overall expenditure, that suggests them taking a 5% haircut.
Whether that comes from one 5% chunk or 100 0.05% chunks who cares. Just do it.
Murph7355 said:
TooMany2cvs said:
And halving the NHS budget is the right solution to that, rather than trimming elsewhere - or increasing income...?
The challenge is that every self interest group comes out of the woodwork and precludes savings in any area (child benefit; student fees; self employed NI; etc etc). I think one of the Scandiwegian countries, in acknowledging this, just said to lop xx% off everything and let each department figure out how. It's a good ploy IMO.
Another typical response is "it's only 0.05% of budgets so why bother?" . There is no single golden bullet IMO. If there was, a political party would have latched onto it by now.
I would say we need to cut a good 15% of our expenditure at least to see us on the right path. If the NHS is a third of overall expenditure, that suggests them taking a 5% haircut.
Whether that comes from one 5% chunk or 100 0.05% chunks who cares. Just do it.
It would also enable unpopular decisions to be made without politicians fearing a loss of support at an election. Unpopular decisions such as instituting co payments which would generate some income and charging for certain services which might reduce demand as well as increase revenue. Of course sidicks will be along to say it's not going to make any difference with his extensive experience of working in the NHS, but I'd suspect the difference would be significant enough to enable funding to be used in a more useful way.
Of course this is a starting point, but the politicisation of the NHS prevents even a discussion about these changes so starting point is sack Hunt and dissolve any party political influence in the DoH in its current guise.
sidicks said:
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oblivious to economics?
I have made what I believe to be a sensible suggestion. You've not explained why this isn't valid nor explained what your alternative solution is. In that case, I'm not sure what you are trying to add to the discussion?
Basic economics is you pay more for a scarce resource.oblivious to economics?
I have made what I believe to be a sensible suggestion. You've not explained why this isn't valid nor explained what your alternative solution is. In that case, I'm not sure what you are trying to add to the discussion?
Your sensible suggestion was to reduce remuneration, doctors in this country are just that, a scarce resource, exampled by my daughters on call last weekend where having been awake and working for 27 hours her speciality had to be declared closed and ambulances diverted as there was no one to take over and she declared herself unsafe to continue. ( I simplify what she told me).
So what I am bringing to the discussion is to ask you to make realistic suggestions and stop shouting down those that clearly have something useful to say.
968 said:
It's not necessary or that simple. A starting point would be to depoliticise the NHS and remove the health secretary and replace the current cretin with a cross party select committee who are in overall leadership but have the CEO of the NHS accountable to them alone. This would instantly stop the continual political meddling that occurs and enable long term planning which is far more cost effective. It would, for instance, have prevented Lansleys disastrous white paper costing upwards of £20bn in reorganisation of the NHS with zero benefit.
It would also enable unpopular decisions to be made without politicians fearing a loss of support at an election. Unpopular decisions such as instituting co payments which would generate some income and charging for certain services which might reduce demand as well as increase revenue. Of course sidicks will be along to say it's not going to make any difference with his extensive experience of working in the NHS, but I'd suspect the difference would be significant enough to enable funding to be used in a more useful way
Yet another ignorant personal comment, rather than address the issue under discussion. How dull.It would also enable unpopular decisions to be made without politicians fearing a loss of support at an election. Unpopular decisions such as instituting co payments which would generate some income and charging for certain services which might reduce demand as well as increase revenue. Of course sidicks will be along to say it's not going to make any difference with his extensive experience of working in the NHS, but I'd suspect the difference would be significant enough to enable funding to be used in a more useful way
How much do you anticipate raising in this way?
968 said:
Of course this is a starting point, but the politicisation of the NHS prevents even a discussion about these changes so starting point is sack Hunt and dissolve any party political influence in the DoH in its current guise.
How much is the current funding shortfall do you suggest, and how is that likely to increase over time?Rovinghawk said:
If posters wish to be seen as intelligent and taken seriously then it would help if they could handle the English language.
As for the NHS, it was originally intended to provide basic care without worrying about doctors' fees. Such things as broken legs & TB.
Scope creep has made the NHS the behemoth that it is today, with the idea that anything & everything should be provided.
My suggestion for starting to cure the problems of the NHS is to reduce the scale of their operations back towards the original concept. Expensive treatments to extend terminal patients' lives by a few weeks are not viable, in the same way as boob enlargements/reductions, IVF and plenty of others. If people want them then they should pay for treatment themselves.
The argument then is which services to provide & which not.
If posters wish to be taken seriously then they really need to stick to the facts and not make nonsensical generalisations. As for the NHS, it was originally intended to provide basic care without worrying about doctors' fees. Such things as broken legs & TB.
Scope creep has made the NHS the behemoth that it is today, with the idea that anything & everything should be provided.
My suggestion for starting to cure the problems of the NHS is to reduce the scale of their operations back towards the original concept. Expensive treatments to extend terminal patients' lives by a few weeks are not viable, in the same way as boob enlargements/reductions, IVF and plenty of others. If people want them then they should pay for treatment themselves.
The argument then is which services to provide & which not.
I think you will find that the original purpose of the NHS was to make health care available free at the point of service. No mention was made of limiting it to broken legs. It removed health care from the remit of councils and ensured national control. Before the war there was a plethora of different businesses providing health care to those who could pay, meaning that illnesses in one area which were treated would kill you in others. Hospitals to an extent depended on the largess of doctors to provide basic care. Certainly a considerable number of experienced doctors would work for a pittance, although many followed the dollar.
The idea that it was set up for A&E and TB is nonsensical. For instance, TB already had its own treatment centres, although again, varying over the country. Many of these were set up at the turn of the century, albeit for reasons of isolation as much as treatment. The NHS therefore had little to do with TB other than to take over these centres. In some areas this was a slow process.
New treatments and better general health care reduced the number of those afflicted and a general rise in the standard of living helped as well. In poorer areas of London immediately post war, there were many families with one or more members suffering from TB.
There was never, ever, any limitations placed on delivery. If you had a serious ailment, nurses did not check a list to see if your particular problem was on it. The emergency side of it hardly changed and there was a fairly efficient form of A&E before the war. Whilst payment was required, it was rarely enforced. Many people were unemployed and had no money.
The death rate for births was over 1% before the war. Much of this was down to amateur midwives, women in the community who were called on to help. They were not allowed to charge unless qualified. If something went badly wrong then hospital was an option, but normally too late. This was the reality for the poor.
Infant mortality was one of the main targets of the NHS and how rapid the drop was showed how effective the NHS was.
Other countries manage to provide effective and efficient health care. If we can’t keep up then rather than the cop out option of fanciful cuts across the board, we should look to these other countries to discover what they do differently.
It would appear that in the majority of these, national health care is supported by all parties. I wonder if that’s a better idea than removing treatment from those seriously ill.
I don’t know the answer to the funding of the NHS. To that extent I’m just like those posters on here who come up with fanciful ideas of stopping treatment of people unlike them. However, I do know what would be a massive step in the right direction: take control away from politicians who regard it as an opportunity to push their mantra.
Whilst the NHS had a lot to do with the overall health of the nation, more or less full employment and a significant rise in the standard of living had a much greater effect.
The history of health care in the UK in the 20th century cannot be described by a simple soundbite. There have been books written on the subject that did not cover every aspect. Glib phrases such as the NHS being set up to cure broken legs and illnesses already being treated should indicate how much credence one should place on posts.
968 said:
It's not necessary or that simple. A starting point would be to depoliticise the NHS and remove the health secretary and replace the current cretin with a cross party select committee who are in overall leadership but have the CEO of the NHS accountable to them alone. This would instantly stop the continual political meddling that occurs and enable long term planning which is far more cost effective. It would, for instance, have prevented Lansleys disastrous white paper costing upwards of £20bn in reorganisation of the NHS with zero benefit.
It would also enable unpopular decisions to be made without politicians fearing a loss of support at an election. Unpopular decisions such as instituting co payments which would generate some income and charging for certain services which might reduce demand as well as increase revenue. Of course sidicks will be along to say it's not going to make any difference with his extensive experience of working in the NHS, but I'd suspect the difference would be significant enough to enable funding to be used in a more useful way.
Of course this is a starting point, but the politicisation of the NHS prevents even a discussion about these changes so starting point is sack Hunt and dissolve any party political influence in the DoH in its current guise.
I suspect we are all in violent agreement that depoliticising the NHS is required. Sidicks included. It would also enable unpopular decisions to be made without politicians fearing a loss of support at an election. Unpopular decisions such as instituting co payments which would generate some income and charging for certain services which might reduce demand as well as increase revenue. Of course sidicks will be along to say it's not going to make any difference with his extensive experience of working in the NHS, but I'd suspect the difference would be significant enough to enable funding to be used in a more useful way.
Of course this is a starting point, but the politicisation of the NHS prevents even a discussion about these changes so starting point is sack Hunt and dissolve any party political influence in the DoH in its current guise.
I suspect we also all agree that charging for some services is needed. ie "free for all at point of service" is outmoded and a millstone.
I'm far from convinced these two items alone are enough, but as you note, they'd be a start. However getting/keeping the momentum going is, I would think, going to need some services to be stopped altogether. And other structural changes (including remuneration structures).
It would also have to be decided what the budget is. That cannot be set by the "CEO" alone. It must be set against other government funding.
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