Sir Keir Starmer Prime Minister
Discussion
Digga said:
768 said:
rdjohn said:
Previous examples of this approach tends to suggests that the same people will get redeployed into very similar roles. The notion that a whole tier will get sacked and need to find a job elsewhere is fatuous.
Shame. 13k roles there could go a long way elsewhere.Making big announcements is actually very easy. But they are simply warm words broken down into soundbites for the media.
Bringing about a genuine change in culture with positive outcomes is dammed hard work, but who is going to be responsible for delivery and where have they demonstrated this ability before?
It takes a visionary and they are few and far between.
As mentioned before, the people below this tier of bureaucracy are all important. They have already failed many times before. The ONS say that productivity of the NHS is currently 18% below the pandemic. Going back to the heady days of 2019 should not seem daunting, and yet it remains illusory.
ChevronB19 said:
philv said:
Nhs England employs well over a million staff.
l.
How to tell someone you’re stating what you think as a fact whilst not realising it’s absolutely not a fact.l.
Well done, best of the day so far!
Tom8 came close with his insistence that you can’t get a senior job in the nhs without previous experience in the NHS, but there is always someone who can do better.
JagLover said:
If they provide a good service at a decent price what would be the issue with that?
The NHS has to change as it isn't providing the level of service it should for what it costs.
Because they have to take profit out of the work, so for the same money you get less service or for the same service you pay more money.The NHS has to change as it isn't providing the level of service it should for what it costs.
skeeterm5 said:
JagLover said:
If they provide a good service at a decent price what would be the issue with that?
The NHS has to change as it isn't providing the level of service it should for what it costs.
Because they have to take profit out of the work, so for the same money you get less service or for the same service you pay more money.The NHS has to change as it isn't providing the level of service it should for what it costs.
M1AGM said:
skeeterm5 said:
JagLover said:
If they provide a good service at a decent price what would be the issue with that?
The NHS has to change as it isn't providing the level of service it should for what it costs.
Because they have to take profit out of the work, so for the same money you get less service or for the same service you pay more money.The NHS has to change as it isn't providing the level of service it should for what it costs.
119 said:
ChevronB19 said:
philv said:
Nhs England employs well over a million staff.
l.
How to tell someone you’re stating what you think as a fact whilst not realising it’s absolutely not a fact.l.
Well done, best of the day so far!
Tom8 came close with his insistence that you can’t get a senior job in the nhs without previous experience in the NHS, but there is always someone who can do better.
This article might help for the terminally dim, other sources are available, all point out that the staff level of NHSE is circa 13k (at the moment).
https://www.theguardian.com/society/2025/mar/10/nh...
ChevronB19 said:
119 said:
ChevronB19 said:
philv said:
Nhs England employs well over a million staff.
l.
How to tell someone you’re stating what you think as a fact whilst not realising it’s absolutely not a fact.l.
Well done, best of the day so far!
Tom8 came close with his insistence that you can’t get a senior job in the nhs without previous experience in the NHS, but there is always someone who can do better.
This article might help for the terminally dim, other sources are available, all point out that the staff level of NHSE is circa 13k (at the moment).
https://www.theguardian.com/society/2025/mar/10/nh...
Skim reading.
ChevronB19 said:
EmBe said:
Currently every UK citizen is entitled to free treatment, but why does it have to be universally free?
Potentially interesting comparison with universal heating allowance, tv licence etc. a lot of people complain about that being removed, but also complain that our healthcare is universally free (at least at the point of need).I love the NHS, I think it is one of the best ideas ever, but I also agree that it has deteriorated into over management and inefficiency. I don’t think you’d find many people who work in the NHS who would disagree with that comment.
But what happened today is the first sign of an absolute fundamental change, and I can’t believe people here who have previously complained about over management etc are now complaining about a government who is actually *doing* something about it.
Unless the DoH has control of the organisation (for better or worse) the current politician on top is unable to do a thing.
I am intrigued as to where this goes both in terms of the issues with the NHS (I don’t expect much saving but I do expect government policy to have a gradual impact unlike now) but also more widely re Quangos in general: it is one of the most baleful aspects of the last 40 years that governmental control has effectively been leeched while the proliferation means the *actual* cost of government is also almost uncontrollable as the treasury and central gov set budgets but have no control after that.
It was a theoretical (and quite Thatcherite) approach which divested central gov of lots of ancillary activity. The impact however was not better government: it was effectively reducing cabinet lead government to a sub department of the treasury.
If labour or the tories or whomever wish to apply radical change let them own it. Farming out to Quangos is a derogation of responsibility.
This change will mean little initially. Apart from the apparent duplicative ‘comms teams’ in health & NHSE.
However longer term if the DoH decides that we all need to live to 100 by way of some pipe dream sold to a gullible public at least they will own it, and the same goes with say dryer Tory (or Reform) aims to shrink or repriortise the monolith that is the NHS.
As it stands any SOS for DoH has precisely no means of doing that bar legislation or Treasury led ‘budget control’ (well also the rolling ‘guidance’ to NHSE).
At the very least it actually puts power back where it should be: in elected politicians.
I suspect the straw that broke the camel’s back was Streeting’s comment that a Dr in the NHS was prioritising recruitment on a racial basis. He has no control over that. Under these reforms I suspect he won’t either but if he keeps on pushing it might be that some of the madness we see might actually be suddenly open to political control.
Sway said:
M1AGM said:
skeeterm5 said:
JagLover said:
If they provide a good service at a decent price what would be the issue with that?
The NHS has to change as it isn't providing the level of service it should for what it costs.
Because they have to take profit out of the work, so for the same money you get less service or for the same service you pay more money.The NHS has to change as it isn't providing the level of service it should for what it costs.
I admire your belief in altruistic businesses and that they will give efficiency savings back to HMG. I am genuinely snuggling to think of a single example where that has happened, ie better service for less money. Can you think of any?
Rail - nope
Water - nope
Telecoms - nope
Prisons - nope
Power - nope
And so on.
It always ends with less service, more cost and massive benefits to shareholders. And in the worst cases the original entity loaded with debt.
Edited by skeeterm5 on Thursday 13th March 19:16
rdjohn said:
And that is the rub.
Making big announcements is actually very easy. But they are simply warm words broken down into soundbites for the media.
Bringing about a genuine change in culture with positive outcomes is dammed hard work, but who is going to be responsible for delivery and where have they demonstrated this ability before?
It takes a visionary and they are few and far between.
As mentioned before, the people below this tier of bureaucracy are all important. They have already failed many times before. The ONS say that productivity of the NHS is currently 18% below the pandemic. Going back to the heady days of 2019 should not seem daunting, and yet it remains illusory.
Pritchard replacement is in place for 2 years. Search Jim Mackey and your questions will be answered on what he has done. In the last 12 months experienced his change at pace attitude and unwillingness to take no for an answer. Seemed highly driven to make a difference and staff were at the heart of a functioning organisation. Making big announcements is actually very easy. But they are simply warm words broken down into soundbites for the media.
Bringing about a genuine change in culture with positive outcomes is dammed hard work, but who is going to be responsible for delivery and where have they demonstrated this ability before?
It takes a visionary and they are few and far between.
As mentioned before, the people below this tier of bureaucracy are all important. They have already failed many times before. The ONS say that productivity of the NHS is currently 18% below the pandemic. Going back to the heady days of 2019 should not seem daunting, and yet it remains illusory.
skeeterm5 said:
Sway said:
M1AGM said:
skeeterm5 said:
JagLover said:
If they provide a good service at a decent price what would be the issue with that?
The NHS has to change as it isn't providing the level of service it should for what it costs.
Because they have to take profit out of the work, so for the same money you get less service or for the same service you pay more money.The NHS has to change as it isn't providing the level of service it should for what it costs.
I admire your belief in altruistic businesses and that they will give efficiency savings back to HMG. I am genuinely snuggling to think of a single example where that has happened, ie better service for less money. Can you think of any?
Rail - nope
Water - nope
Telecoms - nope
Prisons - nope
Power - nope
And so on.
It always ends with less service, more cost and massive benefits to shareholders. And in the worst cases the original entity loaded with debt.
Edited by skeeterm5 on Thursday 13th March 19:16
Ta.
pavarotti1980 said:
119 said:
It appears to be closer to 1.5m.
NHSE do not have 1.5m staff. You are doing the same as other pister and confusing yourself DHSC has around 3500 employees.
It will remain to be seen whether that number can replicate current output. Who knows.
But more precisely that remaining 10k employees will be directly responsible to the SOS of Health and will respond to his policy decisions. Well in theory.
skeeterm5 said:
And you are assuming that private companies won’t want to screw as much money out as possible,
I admire your belief in altruistic businesses and that they will give efficiency savings back to HMG. I am genuinely snuggling to think of a single example where that has happened, ie better service for less money. Can you think of any?
Rail - nope
Water - nope
Telecoms - nope
Prisons - nope
Power - nope
And so on.
It always ends with less service, more cost and massive benefits to shareholders. And in the worst cases the original entity loaded with debt.
You've picked things that are monopolies, the private sector runs monopolies badly.I admire your belief in altruistic businesses and that they will give efficiency savings back to HMG. I am genuinely snuggling to think of a single example where that has happened, ie better service for less money. Can you think of any?
Rail - nope
Water - nope
Telecoms - nope
Prisons - nope
Power - nope
And so on.
It always ends with less service, more cost and massive benefits to shareholders. And in the worst cases the original entity loaded with debt.
Edited by skeeterm5 on Thursday 13th March 19:16
Healthcare isn't a monopoly.
Healthcare would be far better run by the private sector just like car manufacture, insurance, food, clothing, Pretty much anything else you can think of.
ChevronB19 said:
Tom8 said:
Tom8 said:
ChevronB19 said:
blueg33 said:
Tom8 said:
Absolutely. And don't forget the NHS won't recruit anyone without previous NHS experience hence we have this massive failure created and overseen by exactly the same people.
Perhaps they could merge the new organisation with GM Energy as they have absolutely nothing to do.
My bold - that is not true. I was offered a director role in the NHS as part of a drive to recruit people with commercial business experience from the private sector. I turned it down though - great pension poor pay. I would have had to take a 20% pay cut, but I was very interested because having worked alongside the NHS I could see many easily addressed failings.Perhaps they could merge the new organisation with GM Energy as they have absolutely nothing to do.
https://www.jobs.nhs.uk/candidate/jobadvert/C9028-...
5 years NHS experience required.
https://www.jobs.nhs.uk/candidate/jobadvert/C9367-...
"Extensive NHS experience required" But no it never happens....
Extensive experience at a senior management level in the NHS or other public sector organisation of running operational services.
Tom8 - note the ‘or’ part.
The irony given the NHS probably employs more DEI staff than any other organisation.
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