Discussion
Crackie said:
The duplication of roles and lack of inter trust communication might take 20 years to improve; better start straight away then. It would not be expensive to set up a small team to carry out a cost benchmarking exercise between trusts. This benchmarking would look at cost to equivalent services or procure of equivalent materials.
This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.
The cost of a service is set by national tariff. For example an outpatient appointment at a hospital with blood tests, x-rays etc costs the same in Carlisle as it will in Chelsea to the NHS. There is no avoiding it so the only way that trusts can actually save decent money is staffing costs from services This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.
pavarotti1980 said:
Crackie said:
The duplication of roles and lack of inter trust communication might take 20 years to improve; better start straight away then. It would not be expensive to set up a small team to carry out a cost benchmarking exercise between trusts. This benchmarking would look at cost to equivalent services or procure of equivalent materials.
This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.
The cost of a service is set by national tariff. For example an outpatient appointment at a hospital with blood tests, x-rays etc costs the same in Carlisle as it will in Chelsea to the NHS. There is no avoiding it so the only way that trusts can actually save decent money is staffing costs from services This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.
with regard to a previous post about making a start sorting it, it is already happening in very limited ways, but because all trusts are independant as such, the govt dont really seem able to drive it through.
it should be Govt led, and it should be straightforward to instruct, i hope to see something happen...
TooMany2cvs said:
If we go cherry-picking to prove what we want to prove, is that in any way honest? Slovenia is a developed, prosperous, industrialised European country. Why shouldn't it be included as a relevant comparison?
No it's not honest. But including Slovenia and others (as the article suggests) is doing exactly the same thing 
200Plus Club said:
that point literally only applies to a couple of things in the NHS, namely the "cost" of the work done under tariffs, and the NHS Pay scales. everything else within is literally sorted locally, ie most procurement, tendering of supplies, etc etc. all done by different systems generally.
pretty much everything a trust will do apart from drugs, supplies, estates type activities is done through the national tariff.And my point is that you cant have trusts undercutting on that service without using staff reductions to cut costs
Murph7355 said:
TooMany2cvs said:
If we go cherry-picking to prove what we want to prove, is that in any way honest? Slovenia is a developed, prosperous, industrialised European country. Why shouldn't it be included as a relevant comparison?
No it's not honest. But including Slovenia and others (as the article suggests) is doing exactly the same thing If you want to compare with Germany but not Slovenia, then compare with - say - all G20 economies.
If you want to compare relatively locally, then comparing with all 28 current EU countries seems realistic. The comparison the BMJ is using does exactly that.
The comparison it's taking exception to is picking the pre-2004 EU15. You have to admit, that's a strange choice - why that particular accession wave? Why not the pre-2013 EU27? Or the pre-2007 EU25? Or the pre-1995 EU12? Or the pre-1986 EC10? Or the pre-1981 EC9? Or the pre-1973 EC6...?
Rovinghawk said:
968 said:
Rovinghawk said:
Or some of the staff want the NHS run for their best interests rather than those of the paients/taxpayers.
Total nonsense.What's wrong with wanting an organization that you work for to run for your interest? I wouldn't forego my yearly bonus so that company can invest in something. Would you? I'm not going to give them my yearly holiday entitlement.
TooMany2cvs said:
There's a choice. You can compare with every country in the world, or you can compare with a group of similar countries based on whatever criteria you wish - so long as you explain the criteria.
If you want to compare with Germany but not Slovenia, then compare with - say - all G20 economies.
If you want to compare relatively locally, then comparing with all 28 current EU countries seems realistic. The comparison the BMJ is using does exactly that.
The comparison it's taking exception to is picking the pre-2004 EU15. You have to admit, that's a strange choice - why that particular accession wave? Why not the pre-2013 EU27? Or the pre-2007 EU25? Or the pre-1995 EU12? Or the pre-1986 EC10? Or the pre-1981 EC9? Or the pre-1973 EC6...?
Totally agree it's odd. It's obviously done for political reasons.If you want to compare with Germany but not Slovenia, then compare with - say - all G20 economies.
If you want to compare relatively locally, then comparing with all 28 current EU countries seems realistic. The comparison the BMJ is using does exactly that.
The comparison it's taking exception to is picking the pre-2004 EU15. You have to admit, that's a strange choice - why that particular accession wave? Why not the pre-2013 EU27? Or the pre-2007 EU25? Or the pre-1995 EU12? Or the pre-1986 EC10? Or the pre-1981 EC9? Or the pre-1973 EC6...?
I'm not sure comparing us with anyone is ultimately helpful, as without equality across all other fiscal and societal aspects it's pretty meaningless.
By all means look at whatever other countries are doing if they have more positive outcomes in certain areas. But an overall comparison is pointless for anything other than political posturing.
jjlynn27 said:
What a weird question / conclusion.
What's wrong with wanting an organization that you work for to run for your interest? I wouldn't forego my yearly bonus so that company can invest in something. Would you? I'm not going to give them my yearly holiday entitlement.
Consider patients waiting outside in ambulances so that managers can look good on their waiting list times. Multiply that by a thousand other situations.What's wrong with wanting an organization that you work for to run for your interest? I wouldn't forego my yearly bonus so that company can invest in something. Would you? I'm not going to give them my yearly holiday entitlement.
Consider the examples given earlier involving NHS funds used to cover up/spin incompetence.
I stand behind what I said.
TooMany2cvs said:
Rovinghawk said:
Consider patients waiting outside in ambulances so that managers can look good on their waiting list times.
I very, VERY much doubt that has ever happened.http://www.mirror.co.uk/news/uk-news/patients-suff...
http://www.dailymail.co.uk/news/article-515332/A-E...
https://www.theguardian.com/society/2008/feb/17/he...
http://www.telegraph.co.uk/news/9637865/Dont-leave...
http://www.telegraph.co.uk/news/health/news/541219...
https://www.kingsfund.org.uk/projects/general-elec...
http://www.ipswichstar.co.uk/news/ipswich-ambulanc...
Rovinghawk said:
jjlynn27 said:
What a weird question / conclusion.
What's wrong with wanting an organization that you work for to run for your interest? I wouldn't forego my yearly bonus so that company can invest in something. Would you? I'm not going to give them my yearly holiday entitlement.
Consider patients waiting outside in ambulances so that managers can look good on their waiting list times. Multiply that by a thousand other situations.What's wrong with wanting an organization that you work for to run for your interest? I wouldn't forego my yearly bonus so that company can invest in something. Would you? I'm not going to give them my yearly holiday entitlement.
Consider the examples given earlier involving NHS funds used to cover up/spin incompetence.
I stand behind what I said.
You are finding very isolated incidents, which will exist in any organization, and are desperate to present them as standard MO, to justify your prejudices.
I picked random link about ambulances and it's an accusation of Govt minister, that's denied by staff in question (for which they'd have records).
Are there s
tty employees within NHS? Of course that there are. Just as there are stty employees in any organization. By and large, NHS employees that I've met go well beyond what I consider their contractual obligation. And, unlike me, they are not at liberty to tell annoying customers to go f
k themselves (politely, of course), as their business is not wanted.jjlynn27 said:
You started the employees should have the interest of patients/taxpayers in front of their own. That's just stupid, and I tried to explain to you why.
I stated that some do. I provided evidence to support the statement.jjlynn27 said:
I know some medical staff that will willingly sacrifice their own time (unpaid) so they can provide extra service
I'm sure that good staff exist- this doesn't mean that bad staff don't exist.jjlynn27 said:
You are finding very isolated incidents, which will exist in any organization, and are desperate to present them as standard MO, to justify your prejudices.
Lots of these isolated incidents, aren't there? I found that pile in just a couple of minutes. Note that the Kingsfund report references ambulance service records.jjlynn27 said:
Are there stty employees within NHS? Of course that there are.
So we're in agreement that they exist.tty employees within NHS? Of course that there are. jjlynn27 said:
Just as there are stty employees in any organization.
I don't pay for many of them & have a choice as to where I put my custom. My objection focusses on those monopolies for which I am forced to pay.tty employees in any organization.jjlynn27 said:
By and large, NHS employees that I've met go well beyond what I consider their contractual obligation.
I've met a couple of such- I've also met some useless clowns. What's your point here?jjlynn27 said:
they are not at liberty to tell annoying customers to go fk themselves (politely, of course), as their business is not wanted.
Abusive 'customers' should be slung straight out on the street (if not a cell). I've seen some pretty annoying staff, too- they should also be held accountable for their manner.k themselves (politely, of course), as their business is not wanted.Edited by Rovinghawk on Tuesday 12th December 15:56
Rovinghawk said:
jjlynn27 said:
You started the employees should have the interest of patients/taxpayers in front of their own. That's just stupid, and I tried to explain to you why.
I stated that some do so. I provided evidence to supprot the statement.jjlynn27 said:
I know some medical staff that will willingly sacrifice their own time (unpaid) so they can provide extra service
I'm sure that good staff exist- this doesn't mean that bad staff don't exist.jjlynn27 said:
You are finding very isolated incidents, which will exist in any organization, and are desperate to present them as standard MO, to justify your prejudices.
Lots of these isolated incidents, aren't there? I found that pile in just a couple of minutes. Note that the Kingsfund report references ambulance service records.jjlynn27 said:
Are there stty employees within NHS? Of course that there are.
So we're in agreement that they exist.tty employees within NHS? Of course that there are. jjlynn27 said:
Just as there are stty employees in any organization.
I don't pay for many of them & have a choice as to where I put my custom. My objection is to those monopolies for which I am forced to pay.tty employees in any organization.jjlynn27 said:
By and large, NHS employees that I've met go well beyond what I consider their contractual obligation.
I've met a couple of such- I've also met some useless clowns. What's your point here?jjlynn27 said:
they are not at liberty to tell annoying customers to go fk themselves (politely, of course), as their business is not wanted.
Abusive 'customers' should be slung straight out on the street (if not a cell). I've seen some pretty annoying staff, too- they should also be held accountable for their manner.k themselves (politely, of course), as their business is not wanted.It's not about good staff, I asked why should anyone put the interest of their employer in front of their own? It's completely idiotic to expect that.
No not a lot of those isolated incidents. It was explained to you that random link that i've picked from your list (that particular link was from 6 years ago), is an unsubstantiated claim.
I didn't say abusive, that goes without saying. I can tell any ANNOYING customer that their business is not required. I can say that to any customer that costs me money. NHS staff can't do that.
As for you picking and choosing who and what to pay. You are not paying them. You are paying taxes just like everyone else. If it bothers you that much what the taxes are spent on, you always have an option to move to a jurisdiction that appeals more. If you think that you are going to have any saying where your money goes within insurance-based system, you are absolutely clueless.
The funny thing is this thread was resurrected with an cretinous article from telegraph whining about prices of stethoscopes designed to enrage the dumbest of the 'omg, look how they are spending my money!!' brigade.
Edited by jjlynn27 on Tuesday 12th December 16:08
jjlynn27 said:
I asked why should anyone put the interest of their employer in front of their own? It's completely idiotic to expect that.
Idiotic to expect them to do the job they're paid for rather than laze around or line their own pockets? Right.jjlynn27 said:
I can tell any ANNOYING customer that their business is not required. I can say that to any customer that costs me money. NHS staff can't do that.
I have to deal with people I don't like, too. It's called normal life.jjlynn27 said:
You are not paying them. You are paying taxes just like everyone else.
I & others pay, they receive. In return it's not unreasonable for them to do the job they're paid for to the best of their ability.As for your insults about either myself or others, try a more adult debating method.
Edited by Rovinghawk on Tuesday 12th December 19:21
Rovinghawk said:
jjlynn27 said:
I asked why should anyone put the interest of their employer in front of their own? It's completely idiotic to expect that.
Idiotic to expect them to do the job they're paid for rather than laze around or line their own pockets? Right.Rovinghawk said:
jjlynn27 said:
I can tell any ANNOYING customer that their business is not required. I can say that to any customer that costs me money. NHS staff can't do that.
I have to deal with people I don't like, too. It's called normal life.k themselves. They can't. Understood?Rovinghawk said:
jjlynn27 said:
You are not paying them. You are paying taxes just like everyone else.
I & others pay, they receive. In return it's not unreasonable for them to do the job they're paid for to the best of their ability.As it was already explained to you, if you don't like the system, change the system. It's not hard. Given how capable you think that you are, it should walk in a park.
Rovinghawk said:
jjlynn27 said:
I asked why should anyone put the interest of their employer in front of their own? It's completely idiotic to expect that.
Idiotic to expect them to do the job they're paid for rather than laze around or line their own pockets? Right.jjlynn27 said:
I can tell any ANNOYING customer that their business is not required. I can say that to any customer that costs me money. NHS staff can't do that.
I have to deal with people I don't like, too. It's called normal life.jjlynn27 said:
You are not paying them. You are paying taxes just like everyone else.
I & others pay, they receive. In return it's not unreasonable for them to do the job they're paid for to the best of their ability.As for your insults about either myself or others, try a more adult debating method.
Edited by Rovinghawk on Tuesday 12th December 19:21
Your continuous narrative in all these NHS threads is how lazy and self interested the staff are. The opposite is more often the case. Given the lack of resources available (and I don't care how much government spin JagLover likes to regurgitate, the expenditure has not increased at the same rate and effectively is a cut as it is no way keeping up with demand) the staff in most of the NHS go far beyond their contracts or what could be reasonably expected to provide service for their patients. Every single member of staff I have worked with today and every day in my department behaves in an exemplary fashion and the patients know they will get an excellent level of care from them.
The funny thing is the main problem with the NHS remains unaddressed here mainly because it is an inconvenience to acknowledge that politicians and this particular SoS are utterly unable to manage the NHS and are actively impeding it's ability to work as a viable organisation with long term planning due to their politicisation of it and, in the case of Hunt, his sheer bumbling, mendacious incompetence as evidenced by his misuse of statistics to support his evisceration of the junior doctor contracts. This has been shown to be a brazen set of lies and figures taken out of context and subsequent studies have shown his comments were untrue, and indeed the changes to contracts have INCREASED patient harm.
He needs to go. The fact he hasn't demonstrates the sheer contempt this government has for the NHS. It's a total disgrace. If they cared one iota about it, they would have the honesty to have a fundamental rethink about the whole service in a de-politicised way.
Rovinghawk said:
TooMany2cvs said:
Rovinghawk said:
Consider patients waiting outside in ambulances so that managers can look good on their waiting list times.
I very, VERY much doubt that has ever happened.http://www.mirror.co.uk/news/uk-news/patients-suff...
http://www.dailymail.co.uk/news/article-515332/A-E...
https://www.theguardian.com/society/2008/feb/17/he...
http://www.telegraph.co.uk/news/9637865/Dont-leave...
http://www.telegraph.co.uk/news/health/news/541219...
https://www.kingsfund.org.uk/projects/general-elec...
http://www.ipswichstar.co.uk/news/ipswich-ambulanc...
Murph7355 said:
968 said:
...If they cared one iota about it, they would have the honesty to have a fundamental rethink about the whole service in a de-politicised way.
To be fair I think you can say the same thing of any government of the last 30yrs.968 said:
Of course, and I don't exclude any party in my criticism, however, Hunt is the worst SoS there has ever been, hands down.
I don't think I know enough detail about him or his predecessors to materially comment.I wonder how much of the negative view is down to him being at the helm at the worst point to date in NHS history? And from what I read I do wonder how much of the junior doctor fiasco (which I suspect plays a huge part in the negativity) was at his door.
I was never a particular fan of hers years ago, but I do wish people would listen to Anne Widdecombe on the NHS.
My sister's a nurse, along with a reasonable number of close friends and acquaintances. Middle management pissing about seems to be a key theme in their woes. That and the general public - all rights and no responsibilities whatsoever.
I witnessed that first hand when my mum was in for a serious op. Family of the woman in the next berth making a proper pain in the arse of themselves, ignoring the rules, being utterly rude to staff and disturbing everyone else around them in a serious ward. I wouldn't do that job for a million quid a year...at least not without the clout to kick d
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