J Hunt and S Hawking - how do we know...
Discussion
Once again a thread on the NHS descends into personal insults and move no where.
There are hundreds of minor issues and many major ones that is affecting the funding of the NHS. It is a fact that more money is going in, that will always be the case as wage rises, council tax rises, electric and gas rise, these all eat at the budget. Add in the massive increase in population and that is where you see a real cut in money.
So the managers, who have been tasked with saving a huge chunk of money take the easy route and try to cut services instead at looking at all the issues.
968 is spot on, it does need to be taken out of the political arena. All you hear is Tories hate the NHS labour loves it and yet a Labour pioneered the PFI in the NHS and out of 125 that are running labour signed 116 of them and most of the rest were well down the road to completion. The Tories privatising the NHS is wrong but using others to get good value seems fair to me.
The medical staff are taking the brunt of cuts, along with the patients who are seeing longer delays in getting appointment's, I was told 12 weeks to get physio for a bad knee I have, if someone cannot work for 12 weeks that hits tax take etc. The anger is being directed at frontline staff not where it should be.
Everyone is entitled to an opinion but that should be based on knowledge not on clipped articles or soundbites. Before some on here saying how it isn't that bad, go to any A&E and just see how tough it is everyday for those staff. Those of us who have daughters or sons etc. working as Doctors can see the effect the situation is having on them. So far 12 of my daughters year have gone to work abroad due to the new contract, that is a fact and down to Hunt's lies and manipulation. If he went there would be a sense of a new start, but it is so bad that no ambitious politician wants it as it is a career killer another good reason to do as 968 suggests.
Yes we also have to have a discussion on what is paid for on the NHS as it has lost it's way somewhat. Was the NHS designed to give IVF, or to provide drugs for gay men to have unprotected sex, or boob jobs because someone says it is making them depressed, or sex change therapy? If people fall into those groups clearly they will disagree but it is a discussion that should take place and tough decision made.
It is the same as claiming money for health tourists, it should not be an issue but in Bristol the union said they will not ask if someone is eligible as they are not immigration officers, why should that be an issue at all for any sane person to ensure we are not providing care for those who are not entitled or in need of lifesaving aid, ie heart attack.
You cannot remove emotion completely from this subject as it is so important. We cannot have a system where rich live and poor die because they cannot afford care, but we need a proper reform that does away with the bickering and point scoring and get a grip on procurement, back office functions and get value for money.
There are hundreds of minor issues and many major ones that is affecting the funding of the NHS. It is a fact that more money is going in, that will always be the case as wage rises, council tax rises, electric and gas rise, these all eat at the budget. Add in the massive increase in population and that is where you see a real cut in money.
So the managers, who have been tasked with saving a huge chunk of money take the easy route and try to cut services instead at looking at all the issues.
968 is spot on, it does need to be taken out of the political arena. All you hear is Tories hate the NHS labour loves it and yet a Labour pioneered the PFI in the NHS and out of 125 that are running labour signed 116 of them and most of the rest were well down the road to completion. The Tories privatising the NHS is wrong but using others to get good value seems fair to me.
The medical staff are taking the brunt of cuts, along with the patients who are seeing longer delays in getting appointment's, I was told 12 weeks to get physio for a bad knee I have, if someone cannot work for 12 weeks that hits tax take etc. The anger is being directed at frontline staff not where it should be.
Everyone is entitled to an opinion but that should be based on knowledge not on clipped articles or soundbites. Before some on here saying how it isn't that bad, go to any A&E and just see how tough it is everyday for those staff. Those of us who have daughters or sons etc. working as Doctors can see the effect the situation is having on them. So far 12 of my daughters year have gone to work abroad due to the new contract, that is a fact and down to Hunt's lies and manipulation. If he went there would be a sense of a new start, but it is so bad that no ambitious politician wants it as it is a career killer another good reason to do as 968 suggests.
Yes we also have to have a discussion on what is paid for on the NHS as it has lost it's way somewhat. Was the NHS designed to give IVF, or to provide drugs for gay men to have unprotected sex, or boob jobs because someone says it is making them depressed, or sex change therapy? If people fall into those groups clearly they will disagree but it is a discussion that should take place and tough decision made.
It is the same as claiming money for health tourists, it should not be an issue but in Bristol the union said they will not ask if someone is eligible as they are not immigration officers, why should that be an issue at all for any sane person to ensure we are not providing care for those who are not entitled or in need of lifesaving aid, ie heart attack.
You cannot remove emotion completely from this subject as it is so important. We cannot have a system where rich live and poor die because they cannot afford care, but we need a proper reform that does away with the bickering and point scoring and get a grip on procurement, back office functions and get value for money.
Rovinghawk said:
968 said:
we are in fact very underpaid for what we do.
Just about every working person in the country feels that they are underpaid for what they do.968 said:
Perhaps but not everyone can demonstrate they are doing an additional 4 half days extra work for no extra pay, which is vital for the continued running of the whole service. However no consultant is asking for more pay, it's just an illustration of the massive underpayment of a significant number of staff. The juniors similarly do many unpaid hours as do the nurses.
Lots of people do far more than the contracted hours for which they are paid.968 said:
Perhaps but not everyone can demonstrate they are doing an additional 4 half days extra work for no extra pay...
That sounds like something someone stacking shelves would say. Seriously, outside of the public sector everyone in professional careers works unpaid days, weekends, weeks even, you just do what needs to be done. IMO you should be demanding far higher pay and better conditions to put you on a par with other professions, not scuffling around looking for half days. Collective bargaining has utterly failed your profession. The problem I see with a cross party committee is accountability. How would the "customer" (aka voter) give feedback at the ballot box if all the parties were saying it wasn't them, but it was everyone? Our political system would struggle I think.
Other things it struggles with is "drawing the line" and " long term".
Everyone is happy to share their opinion on "drawing the line", provided:
- they don't have to do it, and
- it is always someone else who is affected, not them, and
- they can throw stuff at the person who did, because it's not quite in the right place.
Similarly long term: these improvements in systems that the public sector need so much. If there isn't the money to deliver core services to standards now, there definitely isn't the money to develop and embed a system on the scale needed.
Yes, you might get hr staff from 47 down to 2, but if there isn't the money to "do" it, it won't be done.
And if we want a huge chunk of public spending to be accountable to voters, it has to be run by a politician. They have to be re-elected regularly. How the hell are we ever going to get a system that can decide stuff long term, and not become some faceless, inaccessible corporate entity?
Also, I don't see how the budget can be anything but reactive to need in a demand led service. Yes, shape the "need" through political and medical decisions, but to turn people away because the budget has all been spent is a wrong turn to a very bad place imo...utterly indefensible for a national organisation.
Plus, our economy is routes in the "spend now, pay later" mentally. I don't blame Brown, or Thatcher or whoever. I blame everyone who expects a 1st world standard of living when they know the country can't technically afford it.
(Ok, we might have one a war, and we can afford it whilst people are happy to lend the uk cash, but it can't go on forever, surely.)
Governments are just supplying the punters with what they want. We chose them.
So,
there's a tonne of problems to sort out, even before you can start sorting out the actual problems of the delivery of free-at-point-of-use health care.
Personally I don't think nhs pensions is the right place to look: partly because the nhs needs its staff, partly because I'm in a public pension and am not a hypocrite, and partly to wind up Sidicks.
Head above the parapet practical solutions..?
( I realise giving an answer might open me to criticism, but I can deal with that)
-more enforcement of self help / self responsibility before expecting the nhs to sort you out (but if nhs staff won't enforce overseas checks, there's no chance of them enforcing something like this)
- more preventative work on diet, fitness, lifestyle, mental health, but as ever this needs more investment
- whittle away at "lost cause" treatments, perhaps with a proper conversation about assisted dying
-get nhs finance to cost up the 20 least effective/ most expensive treatments, and have a uk wide referendum on which 5 to end (none of this welsh, Scottish do what you want nonsense)
-It's hard. To do this properly needs the people involved in delivering care to properly set out options and choices that can be made politically, and engage with the necessary debate about how to deliver "less" with less.
But to just repeat "crisis" and "more" seems like a wilful ignorance that health spending has to be addressed at some point (unless people genuinely think health deserves a blank cheque on a gold platter every year regardless of anything)
It's a nice ideal, for sure, but reality is going to bite one day, and I'm sure it would be better to plan the decent now than just nose dive at some future point.
Ian
Other things it struggles with is "drawing the line" and " long term".
Everyone is happy to share their opinion on "drawing the line", provided:
- they don't have to do it, and
- it is always someone else who is affected, not them, and
- they can throw stuff at the person who did, because it's not quite in the right place.
Similarly long term: these improvements in systems that the public sector need so much. If there isn't the money to deliver core services to standards now, there definitely isn't the money to develop and embed a system on the scale needed.
Yes, you might get hr staff from 47 down to 2, but if there isn't the money to "do" it, it won't be done.
And if we want a huge chunk of public spending to be accountable to voters, it has to be run by a politician. They have to be re-elected regularly. How the hell are we ever going to get a system that can decide stuff long term, and not become some faceless, inaccessible corporate entity?
Also, I don't see how the budget can be anything but reactive to need in a demand led service. Yes, shape the "need" through political and medical decisions, but to turn people away because the budget has all been spent is a wrong turn to a very bad place imo...utterly indefensible for a national organisation.
Plus, our economy is routes in the "spend now, pay later" mentally. I don't blame Brown, or Thatcher or whoever. I blame everyone who expects a 1st world standard of living when they know the country can't technically afford it.
(Ok, we might have one a war, and we can afford it whilst people are happy to lend the uk cash, but it can't go on forever, surely.)
Governments are just supplying the punters with what they want. We chose them.
So,
there's a tonne of problems to sort out, even before you can start sorting out the actual problems of the delivery of free-at-point-of-use health care.
Personally I don't think nhs pensions is the right place to look: partly because the nhs needs its staff, partly because I'm in a public pension and am not a hypocrite, and partly to wind up Sidicks.
Head above the parapet practical solutions..?
( I realise giving an answer might open me to criticism, but I can deal with that)
-more enforcement of self help / self responsibility before expecting the nhs to sort you out (but if nhs staff won't enforce overseas checks, there's no chance of them enforcing something like this)
- more preventative work on diet, fitness, lifestyle, mental health, but as ever this needs more investment
- whittle away at "lost cause" treatments, perhaps with a proper conversation about assisted dying
-get nhs finance to cost up the 20 least effective/ most expensive treatments, and have a uk wide referendum on which 5 to end (none of this welsh, Scottish do what you want nonsense)
-It's hard. To do this properly needs the people involved in delivering care to properly set out options and choices that can be made politically, and engage with the necessary debate about how to deliver "less" with less.
But to just repeat "crisis" and "more" seems like a wilful ignorance that health spending has to be addressed at some point (unless people genuinely think health deserves a blank cheque on a gold platter every year regardless of anything)
It's a nice ideal, for sure, but reality is going to bite one day, and I'm sure it would be better to plan the decent now than just nose dive at some future point.
Ian
Ian Geary said:
The problem I see with a cross party committee is accountability. How would the "customer" (aka voter) give feedback at the ballot box if all the parties were saying it wasn't them, but it was everyone? Our political system would struggle I think.
Other things it struggles with is "drawing the line" and " long term".
Everyone is happy to share their opinion on "drawing the line", provided:
- they don't have to do it, and
- it is always someone else who is affected, not them, and
- they can throw stuff at the person who did, because it's not quite in the right place.
Similarly long term: these improvements in systems that the public sector need so much. If there isn't the money to deliver core services to standards now, there definitely isn't the money to develop and embed a system on the scale needed.
Yes, you might get hr staff from 47 down to 2, but if there isn't the money to "do" it, it won't be done.
And if we want a huge chunk of public spending to be accountable to voters, it has to be run by a politician. They have to be re-elected regularly. How the hell are we ever going to get a system that can decide stuff long term, and not become some faceless, inaccessible corporate entity?
Also, I don't see how the budget can be anything but reactive to need in a demand led service. Yes, shape the "need" through political and medical decisions, but to turn people away because the budget has all been spent is a wrong turn to a very bad place imo...utterly indefensible for a national organisation.
Plus, our economy is routes in the "spend now, pay later" mentally. I don't blame Brown, or Thatcher or whoever. I blame everyone who expects a 1st world standard of living when they know the country can't technically afford it.
(Ok, we might have one a war, and we can afford it whilst people are happy to lend the uk cash, but it can't go on forever, surely.)
Governments are just supplying the punters with what they want. We chose them.
So,
there's a tonne of problems to sort out, even before you can start sorting out the actual problems of the delivery of free-at-point-of-use health care.
Personally I don't think nhs pensions is the right place to look: partly because the nhs needs its staff, partly because I'm in a public pension and am not a hypocrite, and partly to wind up Sidicks
Other things it struggles with is "drawing the line" and " long term".
Everyone is happy to share their opinion on "drawing the line", provided:
- they don't have to do it, and
- it is always someone else who is affected, not them, and
- they can throw stuff at the person who did, because it's not quite in the right place.
Similarly long term: these improvements in systems that the public sector need so much. If there isn't the money to deliver core services to standards now, there definitely isn't the money to develop and embed a system on the scale needed.
Yes, you might get hr staff from 47 down to 2, but if there isn't the money to "do" it, it won't be done.
And if we want a huge chunk of public spending to be accountable to voters, it has to be run by a politician. They have to be re-elected regularly. How the hell are we ever going to get a system that can decide stuff long term, and not become some faceless, inaccessible corporate entity?
Also, I don't see how the budget can be anything but reactive to need in a demand led service. Yes, shape the "need" through political and medical decisions, but to turn people away because the budget has all been spent is a wrong turn to a very bad place imo...utterly indefensible for a national organisation.
Plus, our economy is routes in the "spend now, pay later" mentally. I don't blame Brown, or Thatcher or whoever. I blame everyone who expects a 1st world standard of living when they know the country can't technically afford it.
(Ok, we might have one a war, and we can afford it whilst people are happy to lend the uk cash, but it can't go on forever, surely.)
Governments are just supplying the punters with what they want. We chose them.
So,
there's a tonne of problems to sort out, even before you can start sorting out the actual problems of the delivery of free-at-point-of-use health care.
Personally I don't think nhs pensions is the right place to look: partly because the nhs needs its staff, partly because I'm in a public pension and am not a hypocrite, and partly to wind up Sidicks
Ian Geary said:
Head above the parapet practical solutions..?
( I realise giving an answer might open me to criticism, but I can deal with that)
-more enforcement of self help / self responsibility before expecting the nhs to sort you out (but if nhs staff won't enforce overseas checks, there's no chance of them enforcing something like this)
- more preventative work on diet, fitness, lifestyle, mental health, but as ever this needs more investment
- whittle away at "lost cause" treatments, perhaps with a proper conversation about assisted dying
-get nhs finance to cost up the 20 least effective/ most expensive treatments, and have a uk wide referendum on which 5 to end (none of this welsh, Scottish do what you want nonsense)
-It's hard. To do this properly needs the people involved in delivering care to properly set out options and choices that can be made politically, and engage with the necessary debate about how to deliver "less" with less.
But to just repeat "crisis" and "more" seems like a wilful ignorance that health spending has to be addressed at some point (unless people genuinely think health deserves a blank cheque on a gold platter every year regardless of anything)
It's a nice ideal, for sure, but reality is going to bite one day, and I'm sure it would be better to plan the decent now than just nose dive at some future point.
Ian
( I realise giving an answer might open me to criticism, but I can deal with that)
-more enforcement of self help / self responsibility before expecting the nhs to sort you out (but if nhs staff won't enforce overseas checks, there's no chance of them enforcing something like this)
- more preventative work on diet, fitness, lifestyle, mental health, but as ever this needs more investment
- whittle away at "lost cause" treatments, perhaps with a proper conversation about assisted dying
-get nhs finance to cost up the 20 least effective/ most expensive treatments, and have a uk wide referendum on which 5 to end (none of this welsh, Scottish do what you want nonsense)
-It's hard. To do this properly needs the people involved in delivering care to properly set out options and choices that can be made politically, and engage with the necessary debate about how to deliver "less" with less.
But to just repeat "crisis" and "more" seems like a wilful ignorance that health spending has to be addressed at some point (unless people genuinely think health deserves a blank cheque on a gold platter every year regardless of anything)
It's a nice ideal, for sure, but reality is going to bite one day, and I'm sure it would be better to plan the decent now than just nose dive at some future point.
Ian
Rovinghawk said:
Is that per week? Per month? Per year?
Lots of people do unpaid overtime- it pretty much goes with the territory for any professional career.
It's per week. Yes lots of people do overtime but probably are paid more basic salary by the hour than a doctor and usually get bonuses. Secondly as said before, it's not a complaint but demonstrative of the value for money we provide which has been questioned here and on other threads. Contract negotiations have been a failure and the coming one will be far far worse.Lots of people do unpaid overtime- it pretty much goes with the territory for any professional career.
968 said:
It's per week. Yes lots of people do overtime but probably are paid more basic salary by the hour than a doctor and usually get bonuses.
Some will be, plenty won't be. Plenty also won't receive (meaningful) bonuses and the vast majority won't have massive pension benefits.968 said:
Secondly as said before, it's not a complaint but demonstrative of the value for money we provide which has been questioned here and on other threads.
Who has questioned the value doctors provide?968 said:
It's per week. Yes lots of people do overtime but probably are paid more basic salary by the hour than a doctor and usually get bonuses. Secondly as said before, it's not a complaint but demonstrative of the value for money we provide which has been questioned here and on other threads. Contract negotiations have been a failure and the coming one will be far far worse.
You know you said people commenting know nothing about your line of work...? 
I think you would be surprised at the number of people working beyond contracted hours who are on significantly less than doctors.
As I noted earlier, I think doctors/nurses (my sister's the latter) deserve a higher rate of pay. But the system currently cannot afford it.
A radical rethink on the demand side of the equation is needed. Along with your suggestion of extra charging for elements of supply (which would in themselves sort some of the demand issues - I wonder how GP appointments would fall if a £20 charge was levied).
I think the same applies to a lot of public welfare expenditure. The usual arguments that come back are that it's too expensive to implement change or the savings for 'x' are peanuts so it's not worth bothering. So we stick our heads in the sand and carry on as we always have. It's stupid.
968 said:
The starting point is getting rid of the health secretary and the toxic influence of party politics.
So who - at government level - is responsible, if there's no health secretary?Who sets priorities and directions, if there's no government influence?
Is it just one particular political party you see as "toxic" for the NHS, or is there no political party that could ever be anything but?
968 said:
It's per week.
Four extra half days per week= 2 extra days per week.Are you telling me that doctors all work 7 days per week & never have a day off? Really? That would be slightly illegal.
Or is it 2 extra days on top of a shorter working week? I don't think we're hearing the full story here.
Rovinghawk said:
Four extra half days per week= 2 extra days per week.
Are you telling me that doctors all work 7 days per week & never have a day off? Really? That would be slightly illegal.
Or is it 2 extra days on top of a shorter working week? I don't think we're hearing the full story here.
Surely he means that, like many people, he is contracted to work for 7 hours per day, but actually works for 10 1/2?Are you telling me that doctors all work 7 days per week & never have a day off? Really? That would be slightly illegal.
Or is it 2 extra days on top of a shorter working week? I don't think we're hearing the full story here.
TooMany2cvs said:
So who - at government level - is responsible, if there's no health secretary?
Who sets priorities and directions, if there's no government influence?
Is it just one particular political party you see as "toxic" for the NHS, or is there no political party that could ever be anything but?
I guess we'd need to define "government". Who sets priorities and directions, if there's no government influence?
Is it just one particular political party you see as "toxic" for the NHS, or is there no political party that could ever be anything but?
But in principle nobody in government needs to be responsible. Someone outside of government can be.
The whole point is to remove government from the loop as far as possible as that's the only way to stop it being a football.
Setting direction and priorities I would sooner was done by medical professionals generally. To think that "government" are equipped to do this without unnecessary meddling is nuts.
IMO no political party is healthy for the NHS. I don't think the electorate are either.
Let government be pivotal in setting out what can be afforded. Let a professional team then deal with what it gets spent on.
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