Discussion
In the private sector each year there is a budgeting process which eventually produces the AGREED business forecast for the following year and is detailed at various line items from revenue through all the various itemised business costs through to the expected business profit.
The NHS management perform a similar process and must surely arrive at an AGREED budget.
I consistently fail to understand why the NHS appears to run out of money every year and has a crisis as winter approaches.
These events occur every year and therefore should be accommodated within the budget setting process.
Companies of course may fail to achieve their budget and when that happens serious questions get asked.
Deviation to budget through the year results in actions to get back on track to achieve budget.
Consistent failure to achieve results in management changes and even dismissals.
I don't understand why when the NHS claims yet again to have run out of money that the media immediately blames the government and demands that more be spent. In my mind the media should be asking the NHS chiefs why they can't budget and if they will be resigning due their failure to produce an accurate budget. What are the demands on the service that they failed to forecast and plan for that results in £ billions of overspend?
Why has action not been taken to get departments or services back on budget?
Cold weather, Saturday night A&E admissions and all the other headline issues occur every year and should be budgeted accordingly.
This is separate to any discussion on how much the country should spend on health as that is a more strategic question.
The NHS management perform a similar process and must surely arrive at an AGREED budget.
I consistently fail to understand why the NHS appears to run out of money every year and has a crisis as winter approaches.
These events occur every year and therefore should be accommodated within the budget setting process.
Companies of course may fail to achieve their budget and when that happens serious questions get asked.
Deviation to budget through the year results in actions to get back on track to achieve budget.
Consistent failure to achieve results in management changes and even dismissals.
I don't understand why when the NHS claims yet again to have run out of money that the media immediately blames the government and demands that more be spent. In my mind the media should be asking the NHS chiefs why they can't budget and if they will be resigning due their failure to produce an accurate budget. What are the demands on the service that they failed to forecast and plan for that results in £ billions of overspend?
Why has action not been taken to get departments or services back on budget?
Cold weather, Saturday night A&E admissions and all the other headline issues occur every year and should be budgeted accordingly.
This is separate to any discussion on how much the country should spend on health as that is a more strategic question.
langtounlad said:
In the private sector each year there is a budgeting process which eventually produces the AGREED business forecast for the following year and is detailed at various line items from revenue through all the various itemised business costs through to the expected business profit.
The NHS management perform a similar process and must surely arrive at an AGREED budget.
I consistently fail to understand why the NHS appears to run out of money every year and has a crisis as winter approaches.
These events occur every year and therefore should be accommodated within the budget setting process.
Companies of course may fail to achieve their budget and when that happens serious questions get asked.
Deviation to budget through the year results in actions to get back on track to achieve budget.
Consistent failure to achieve results in management changes and even dismissals.
I don't understand why when the NHS claims yet again to have run out of money that the media immediately blames the government and demands that more be spent. In my mind the media should be asking the NHS chiefs why they can't budget and if they will be resigning due their failure to produce an accurate budget. What are the demands on the service that they failed to forecast and plan for that results in £ billions of overspend?
Why has action not been taken to get departments or services back on budget?
Cold weather, Saturday night A&E admissions and all the other headline issues occur every year and should be budgeted accordingly.
This is separate to any discussion on how much the country should spend on health as that is a more strategic question.
Not enough is spent to accommodate the level of ever-increasing demand. Population are getting fatter and older, for starters. Doc/nurses are leaving the profession (or just NHS in some cases) and then you have to rely on external (expensive) staff. Just for that, budget, from memory, for 2016 was £1b, it ended costing more than £2.7b. The NHS management perform a similar process and must surely arrive at an AGREED budget.
I consistently fail to understand why the NHS appears to run out of money every year and has a crisis as winter approaches.
These events occur every year and therefore should be accommodated within the budget setting process.
Companies of course may fail to achieve their budget and when that happens serious questions get asked.
Deviation to budget through the year results in actions to get back on track to achieve budget.
Consistent failure to achieve results in management changes and even dismissals.
I don't understand why when the NHS claims yet again to have run out of money that the media immediately blames the government and demands that more be spent. In my mind the media should be asking the NHS chiefs why they can't budget and if they will be resigning due their failure to produce an accurate budget. What are the demands on the service that they failed to forecast and plan for that results in £ billions of overspend?
Why has action not been taken to get departments or services back on budget?
Cold weather, Saturday night A&E admissions and all the other headline issues occur every year and should be budgeted accordingly.
This is separate to any discussion on how much the country should spend on health as that is a more strategic question.
jjlynn27 said:
Not enough is spent to accommodate the level of ever-increasing demand. Population are getting fatter and older, for starters. Doc/nurses are leaving the profession (or just NHS in some cases) and then you have to rely on external (expensive) staff. Just for that, budget, from memory, for 2016 was £1b, it ended costing more than £2.7b.
That actually helps prove my point.Population getting older / fatter isn't a new phenomenon and should be accommodated within a 3-5 year planning horizon.
Doctors and Nurses leaving may be at a higher rate than forecast but the deviation in costs vs the total NHS budget is tiny.
The bigger point in that area is why have we been so reliant on 'foreign' workers coming from overseas rather than training sufficient numbers in the UK?
That is an area where lack of strategic planning is now causing additional costs.
langtounlad said:
In the private sector each year there is a budgeting process which eventually produces the AGREED business forecast for the following year and is detailed at various line items from revenue through all the various itemised business costs through to the expected business profit.
The NHS management perform a similar process and must surely arrive at an AGREED budget.
I consistently fail to understand why the NHS appears to run out of money every year and has a crisis as winter approaches.
These events occur every year and therefore should be accommodated within the budget setting process.
Companies of course may fail to achieve their budget and when that happens serious questions get asked.
Deviation to budget through the year results in actions to get back on track to achieve budget.
Consistent failure to achieve results in management changes and even dismissals.
I don't understand why when the NHS claims yet again to have run out of money that the media immediately blames the government and demands that more be spent. In my mind the media should be asking the NHS chiefs why they can't budget and if they will be resigning due their failure to produce an accurate budget. What are the demands on the service that they failed to forecast and plan for that results in £ billions of overspend?
Why has action not been taken to get departments or services back on budget?
Cold weather, Saturday night A&E admissions and all the other headline issues occur every year and should be budgeted accordingly.
This is separate to any discussion on how much the country should spend on health as that is a more strategic question.
This is a strange viewpoint. As far as I can see, a given NHS trust has no control over the demand on it, so little control over its expenses, and no control over the amount of money it gets beyond pleading with the Government for more. It doesn't matter how many budget planning meetings you have, there comes a point at which you're making bricks without straw.The NHS management perform a similar process and must surely arrive at an AGREED budget.
I consistently fail to understand why the NHS appears to run out of money every year and has a crisis as winter approaches.
These events occur every year and therefore should be accommodated within the budget setting process.
Companies of course may fail to achieve their budget and when that happens serious questions get asked.
Deviation to budget through the year results in actions to get back on track to achieve budget.
Consistent failure to achieve results in management changes and even dismissals.
I don't understand why when the NHS claims yet again to have run out of money that the media immediately blames the government and demands that more be spent. In my mind the media should be asking the NHS chiefs why they can't budget and if they will be resigning due their failure to produce an accurate budget. What are the demands on the service that they failed to forecast and plan for that results in £ billions of overspend?
Why has action not been taken to get departments or services back on budget?
Cold weather, Saturday night A&E admissions and all the other headline issues occur every year and should be budgeted accordingly.
This is separate to any discussion on how much the country should spend on health as that is a more strategic question.
langtounlad said:
That actually helps prove my point.
Population getting older / fatter isn't a new phenomenon and should be accommodated within a 3-5 year planning horizon.
Not sure that it does. Simon Stevens asked for a lot more money to cover the raising expectations. Money was not given.Population getting older / fatter isn't a new phenomenon and should be accommodated within a 3-5 year planning horizon.
For the analogy to the private sector (completely random numbers); You need a budget of £1m in order to service 1000 cars. You are given £600k and told that you need to service all of those cars.
langtounlad said:
Doctors and Nurses leaving may be at a higher rate than forecast but the deviation in costs vs the total NHS budget is tiny.
The problem is that huge majority of them work stupid hours, and some of the overtime is not paid. That's not sustainable. You also have drop in the pound that compounds the effect of external locums willingness to come and work on longer term contracts. langtounlad said:
The bigger point in that area is why have we been so reliant on 'foreign' workers coming from overseas rather than training sufficient numbers in the UK?
That is an area where lack of strategic planning is now causing additional costs.
Answer to the 99% of the questions is; money. It cost over £500k to train a doctor (in addition to their own significant contributions). That is an area where lack of strategic planning is now causing additional costs.
The only way to stop the NHS from collapse is a cross party agreement,a long term policy and a stop to the political point winning we see from whoever is in opposition.
Then we need a cull of inept managers,jobs for the boys,who fail at one trust,given a pay off and then enployed by another trust.
Just throwing money at it will never fix the NHS
Then we need a cull of inept managers,jobs for the boys,who fail at one trust,given a pay off and then enployed by another trust.
Just throwing money at it will never fix the NHS
Jockman said:
Agreed on the whole. Disagree on the IVF obviously as it gave me my youngest grandson.
The only logical solution seems to be rationing - they do this with IVF - to try and satisfy as many competing interests for scarce resources.
Rationing is unlikely to work in the majority of cases though.The only logical solution seems to be rationing - they do this with IVF - to try and satisfy as many competing interests for scarce resources.
The science of IVF gave you your grandson. I know this is blunt, but I see no reason why it should be provided on the NHS as in the overall scheme of bringing kids up, the cost of IVF cycles is nothing.
I agree with the other items spaximus notes. And there will be quite long lists of similar items that could (and should IMO) simply be cut from the budget. As he notes (and as you've ably demonstrated Jockers
), people with self interests will always prevent any material change. The problem with that is that when the system does eventually break, there will be no service for anyone and the truly poor will be the ones who suffer the most. Surely it's better that we start being realistic now?jjlynn27 said:
gooner1 said:
jjlynn27 said:
nikaiyo2 said:
Hmmm is this the same Bob Kerslake who was employed by the Labour Party?
Btw, fashioned anything useful from your notorious length of timber yet? A crutch
for your lame humour perhaps.
gooner1 said:
jjlynn27 said:
gooner1 said:
jjlynn27 said:
nikaiyo2 said:
Hmmm is this the same Bob Kerslake who was employed by the Labour Party?
Btw, fashioned anything useful from your notorious length of timber yet?
I didn't know that my 'length of timber' is notorious!
gooner1 said:
A crutch
for your lame humour perhaps.
The fantastically delicious irony. for your lame humour perhaps.
Jonesy23 said:
"King's College Hospital NHS Trust revenue rose from £1,058,789,000 to £1,110,219,000 between 2016 and 2017, a rise of 4.8%."
'Underfunded'.
Look at government spending and Health is the only area that has seen large real terms increases since 2010.'Underfunded'.
If the NHS is nearing collapse regardless then it needs systematic reform.
As a starting point abandon or heavily ration many "non essential" treatments and ensure that all foreign residents are paying the full cost of their treatment. Other countries require health insurance as part of travel insurance before you can enter the country, why don't we?
EliseNick said:
This is a strange viewpoint. As far as I can see, a given NHS trust has no control over the demand on it, so little control over its expenses, and no control over the amount of money it gets beyond pleading with the Government for more. It doesn't matter how many budget planning meetings you have, there comes a point at which you're making bricks without straw.
A trust may not have a control over the demand but it does have information on the demand trend over time and should therefore be able to predict the demand to a reasonable level of accuracy from one year to another and over a 3 to 5 year planning timeframe.My original post highlighted that budgets are AGREED by both sides and then performance is measured vs the plan.
If NHS chiefs are unable to reach agreement with government that is the time to complain or resign on principle.
Part of the negotiation should include what is able to be delivered vs the budget funding.
But once the plan is AGREED an inability to achieve the budget is a failure of the NHS management & staff.
I include staff in the failure as I suspect that much of the failure to achieve efficiencies is resistance from staff and budget holders.
But overall it is a senior management failure to manage the budget negotiations correctly with government and then work the budget.
jjlynn27 said:
gooner1 said:
jjlynn27 said:
gooner1 said:
jjlynn27 said:
nikaiyo2 said:
Hmmm is this the same Bob Kerslake who was employed by the Labour Party?
OBtw, fashioned anything useful from your notorious length of timber yet?
I didn't know that my 'length of timber' is notorious!
gooner1 said:
A crutch
for your lame humour perhaps.
The fantastically delicious irony. for your lame humour perhaps.
Not sure if laughing at one's own comments makes them any more funny, but don't
let me put you off. You carry on Rolfing at yourself. I may even join in.
JagLover said:
Jonesy23 said:
"King's College Hospital NHS Trust revenue rose from £1,058,789,000 to £1,110,219,000 between 2016 and 2017, a rise of 4.8%."
'Underfunded'.
Look at government spending and Health is the only area that has seen large real terms increases since 2010.'Underfunded'.
If the NHS is nearing collapse regardless then it needs systematic reform.
As a starting point abandon or heavily ration many "non essential" treatments and ensure that all foreign residents are paying the full cost of their treatment. Other countries require health insurance as part of travel insurance before you can enter the country, why don't we?
And blame the foreigners, PH bingo.
JagLover said:
Look at government spending and Health is the only area that has seen large real terms increases since 2010.
When you take into account an increase in demand, it didn't see an increase since 2010. On the contrary. Concentrating on IVF and occasional boob job works well for the DM readership to get angry about. In the great scheme of things they are completely irrelevant, rounding errors.
gooner1 said:
Your timber is almost as notorious as your Bridge ,
Not sure if laughing at one's own comments makes them any more funny, but don't
let me put you off. You carry on Rolfing at yourself. I may even join in.
What length of timber, you tool? You sure that you didn't get your stories muddled up?Not sure if laughing at one's own comments makes them any more funny, but don't
let me put you off. You carry on Rolfing at yourself. I may even join in.
Have another one
Of course, going back to Kings, it’s fascinating how the usual PH finance/private sector moguls have pronounced judgement without the slightest understanding why they’re in trouble.
They’re in trouble because Jeremy
, practically forced them to take over another failing trust in 2013, crippled by a hugely expensive PFI, that being Princess Royal University Hospital. This, in addition to the ongoing closure/downgrading of south east London hospitals like Lewisham, Sidcup and others means that demand has spiralled out of all proportion to resources available, all against the backdrop of supporting a failing trust financially.
Kings used to be one of the few trusts that was in the black, consistently, now it’s collapsing under the strain put on it with no additional resources, all due to the SoS being an incompetent tt.
They’re in trouble because Jeremy
, practically forced them to take over another failing trust in 2013, crippled by a hugely expensive PFI, that being Princess Royal University Hospital. This, in addition to the ongoing closure/downgrading of south east London hospitals like Lewisham, Sidcup and others means that demand has spiralled out of all proportion to resources available, all against the backdrop of supporting a failing trust financially.Kings used to be one of the few trusts that was in the black, consistently, now it’s collapsing under the strain put on it with no additional resources, all due to the SoS being an incompetent t
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