Discussion
PH XKR said:
The biggest issue for the nhs is the attitude of staff within the nhs. They fight internally and trust to trust.
What is needed is a private sector approach to management but one not driven to please share holders.
Given we are the shareholders, I think a private sector approach designed to deliver for us within budgets is exactly what is required.What is needed is a private sector approach to management but one not driven to please share holders.
NHS: research suggests it is a classically chaotic system (think swarm of bees rather than a large beach ball) and therefore requires a HUGE input to change direction - in money terms, perhaps 10x annual budget.
Breaking it into manageable chunks would help. Upping spending to match other decent countries might help, too.
Regarding other points, UK's problems are mainly housing cost, with a side order of black market. Fix those and a lot of other stuff will start to work. No problem with raising income tax - works fine in other countries.
Starting now, in no particular order, these would be a start:
- fix net immigration
- tax out of existence / prohibit overseas property ownership (ownership by a U.K. Company ok, but no funding by overseas debt - equity only, and no allowable interest costs
- ban payment in cash for businesses (a pain maybe, but really no biggie in this day and age)
- introduce protected rents legislation
- scrap ASTs and reintroduce security of tenure for tenants
- prevent further conversion of commercial property to residential
Are these harsh? Yes. But we can't be the world's market when it destroys our own society. Our citizens are not here to generate profits for overseas property investors, nor are tenants just fuel for the economic mill.
The current situation is intolerable and unsustainable. The black economy is rampant. Basic rule of law (certainly in business) has just about broken down in many places. It is considered normal to be bent all over the place.
Those are the things many voting for Brexit wanted to "fix" but honestly Brexit won't fix them.
All IMHO of course
Breaking it into manageable chunks would help. Upping spending to match other decent countries might help, too.
Regarding other points, UK's problems are mainly housing cost, with a side order of black market. Fix those and a lot of other stuff will start to work. No problem with raising income tax - works fine in other countries.
Starting now, in no particular order, these would be a start:
- fix net immigration
- tax out of existence / prohibit overseas property ownership (ownership by a U.K. Company ok, but no funding by overseas debt - equity only, and no allowable interest costs
- ban payment in cash for businesses (a pain maybe, but really no biggie in this day and age)
- introduce protected rents legislation
- scrap ASTs and reintroduce security of tenure for tenants
- prevent further conversion of commercial property to residential
Are these harsh? Yes. But we can't be the world's market when it destroys our own society. Our citizens are not here to generate profits for overseas property investors, nor are tenants just fuel for the economic mill.
The current situation is intolerable and unsustainable. The black economy is rampant. Basic rule of law (certainly in business) has just about broken down in many places. It is considered normal to be bent all over the place.
Those are the things many voting for Brexit wanted to "fix" but honestly Brexit won't fix them.
All IMHO of course
Agreed.
I'm in the building industry and there's so many cash jobs going on, we don't do any, it's not worth the risk.
But frequently get customers demanding even offended that we won't knock the VAT off.
Frequently loose work to other companies who will as they're 20% cheaper straight away.
But no one seems to address this, why can't we just get rid of cash and raise billions in tax revenue from everyone who's on the take rather than taxing hard working people more who are struggling to compete with people who are paying none.
I'm in the building industry and there's so many cash jobs going on, we don't do any, it's not worth the risk.
But frequently get customers demanding even offended that we won't knock the VAT off.
Frequently loose work to other companies who will as they're 20% cheaper straight away.
But no one seems to address this, why can't we just get rid of cash and raise billions in tax revenue from everyone who's on the take rather than taxing hard working people more who are struggling to compete with people who are paying none.
Colonial said:
This has never been an impediment to countless PMs, Presidents, Monarchs or Tribal leaders the world over.
There's good creepy then there is farron creepy.I bet he has one of those noncommittal limp handshakes too or the overcompensating hulk grip. Never trust a man who doesn't know how to shake another mans hand. I just dont feel he knows how to
Colonial said:
Yipper said:
That Tim dude looks, sounds and acts a bit creepy. He has no chance of becoming PM.
This has never been an impediment to countless PMs, Presidents, Monarchs or Tribal leaders the world over. Exhibit A:
https://en.m.wikipedia.org/wiki/Ed_Miliband_bacon_...
Exhibit B:
https://www.scientificamerican.com/article/the-loo...
Rich_W said:
Biker 1 said:
jmorgan said:
News telling me that "Tim nice but who" wants to tax me more to fund the NHS.
Not that I was going to vote for him anyway.
I think they're talking about £6 billion in revenue. But therein lies the problem: it seems that however much ££££ is ploughed into the NHS, it seems to be ALWAYS in some sort of state of crisis. For as long as I can remember, it appears to be teetering on the edge of calamity. As pointed out by others, perhaps its time for a full scale re-hash, rather than tinkering around the edges. The ginger one is not being clever on this one.Not that I was going to vote for him anyway.
But propose modernizing it and the f
kwit wkers appear and claim the Tories are "privatising" the NHS by the back door. Some of the st I've heard from Corbynites since the election was announced. 
1 actually claimed that in 5 years the NHS wont exist anymore!OK, so I'm genuinely not a conspiracy theorist, but on the topic of why people do - or do not - vote a certain way, some might this of interest:
https://www.theguardian.com/technology/2017/may/07...
15 or more years ago, I believed that the social contract between the governed and the governors was breaking down; Blair was the symptom, I believed, because he was the first to openly ignore the conventions of office in favour of the simple exercise of power. And now we are where we are. And there's an interesting and very open position for an honourable new leader.
The question, of course, is whether Farron is it? But May most certainly is not; and neither is Corbyn.
https://www.theguardian.com/technology/2017/may/07...
15 or more years ago, I believed that the social contract between the governed and the governors was breaking down; Blair was the symptom, I believed, because he was the first to openly ignore the conventions of office in favour of the simple exercise of power. And now we are where we are. And there's an interesting and very open position for an honourable new leader.
The question, of course, is whether Farron is it? But May most certainly is not; and neither is Corbyn.
jmorgan said:
Yep, chuck money at it. What can get worse. At least they can have nicer carpets at head office and replace kitchens less than a year old more often.
The NHS as-is is unmanageable IMO. Spending is too low in any case, but the management structures are impossible too.We need to hire decent people and back them. Often the year-old kitchen problem is because of third parties - nobody wants to say a consultant or contractor is wrong, because accepting what they say is safe. The old "nobody ever got fired for buying IBM" mantra:
I'm sure there are efficiencies available also. But making the thing manageable and less of a political football would be good. My wife has recently been treated by a BMI hospital under contract to the NHS - chalk and cheese compared to the local NHS hospital. Not ambience (no difference) but instead the approach - follow-ups in particular just far better, as a result of a can-do attitude.
I have no problem with introducing business attitudes to the NHS, but I will not stand for it being hived-off to provide revenues for foreign companies.
glazbagun said:
Colonial said:
Yipper said:
That Tim dude looks, sounds and acts a bit creepy. He has no chance of becoming PM.
This has never been an impediment to countless PMs, Presidents, Monarchs or Tribal leaders the world over. Exhibit A:
https://en.m.wikipedia.org/wiki/Ed_Miliband_bacon_...
Exhibit B:
https://www.scientificamerican.com/article/the-loo...
Biker 1 said:
skwdenyer said:
The NHS as-is is unmanageable IMO.
Seems to be the elephant in the room that no politician is prepared to tackle.The funding levels and management are, of course, a political issue. But the institutions themselves - hospitals, clinics, etc. - must not be. Thankfully the days of endless strikes seem to be over - the people on the ground are no longer playing politics. So the next step is?
There are a lot of people have spent years studying the NHS, as it is such a behemoth - it is used as a teaching ground for management academics the world over.
But the funding is way too low.
Where will that come from? I'm afraid I'm the iconoclast on this; collapse the housing bubble and, in consequence, slash the housing benefit bill.
In 2015, Housing Benefit was £43bn in England and Wales. NHS spending was around £130bn. Cut private rents by 10% across the board and - very crudely - lop £4.5bn off of the housing benefit bill. Drop 20% and gain £9bn for other uses. Drop 30% (which is rather more sensible an ambition) and you've got almost £14bn to spend.
£14bn would be 11% of the NHS budget. We need an increase of 30% to match our European neighbours' spending, but that would cover a lot of the gap.
If housing costs dropped 30% on average, there would be enough room for a small increase in tax / NIC to cover the rest of the gap.
It is the costs of real living that are killing the UK, IMHO, starting with housing. Everything else needs to take second place to making sure that people can actually have a decent standard of living and care in a decently-wealthy country.
There's nothing else to cut. IMO
Yipper said:
Yes, humans vote by sight. Some studies suggest up to 90% of a voting decision is consciously or subconsciously made on whether a person "looks right" (tall, calm, pleasant voice, etc.). Tim Farron looks like the kind of person with white flecks of spit in the corner of his mouth and is very unlikely to become PM or be sustainably successful.
You've posted some right old arse on this thread. 
skwdenyer said:
Where will that come from? I'm afraid I'm the iconoclast on this; collapse the housing bubble and, in consequence, slash the housing benefit bill.
All rather simplistic IMO. I work in the building industry, & even if supply/demand is met, particularly in SE England, I do not believe it is possible to cut the cost of housing by 30%, based on what they cost to build. The red tape, planning 'system', NIMBYs, green belt restrictions, etc etc, will all collude to confound.skwdenyer said:
£14bn would be 11% of the NHS budget. We need an increase of 30% to match our European neighbours' spending, but that would cover a lot of the gap.
You're not comparing like with like. The only reason that the European neighbours funding looks so much more is because they have a mixed public/private model and using the combined figures against the ones just for the public funding of the NHS makes the NHS look far more underfunded than it is. Fastdruid said:
skwdenyer said:
£14bn would be 11% of the NHS budget. We need an increase of 30% to match our European neighbours' spending, but that would cover a lot of the gap.
You're not comparing like with like. The only reason that the European neighbours funding looks so much more is because they have a mixed public/private model and using the combined figures against the ones just for the public funding of the NHS makes the NHS look far more underfunded than it is. Public sector spending on healthcare totalled £125.5 billion in 2013 and accounted for 83.3% of total healthcare expenditure in the UK, with the remaining £25.1 billion being private sector spending.
https://www.ons.gov.uk/peoplepopulationandcommunit...
http://www.telegraph.co.uk/business/2017/04/17/uk-...
Many have felt this is the case but now academic research agrees with the assertion that it is practically impossible to build enough homes in this country to dampen the market by classic supply side economics.
Personally I think we need to massively spend on infrastructure and frankly keep the people flooding in from overseas as this is growing our economy. The UK is a perverse little island as we have vast swathes of the country that are fairly rural and/or have really crap transport infrastructure (Dorset west of Poole a perfect example, its where all the major roads end up back like how they where in the 70s). Everyone crammed into the major urban conurbations. Grow your way out of debt, we did it in the 19th century when debt to GDP was over 250%.
Many have felt this is the case but now academic research agrees with the assertion that it is practically impossible to build enough homes in this country to dampen the market by classic supply side economics.
Personally I think we need to massively spend on infrastructure and frankly keep the people flooding in from overseas as this is growing our economy. The UK is a perverse little island as we have vast swathes of the country that are fairly rural and/or have really crap transport infrastructure (Dorset west of Poole a perfect example, its where all the major roads end up back like how they where in the 70s). Everyone crammed into the major urban conurbations. Grow your way out of debt, we did it in the 19th century when debt to GDP was over 250%.
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