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Stephen Hawking Is Taking Legal Action Against Jeremy Hunt

I have no love of the Capita etc - they are public service organisations set up to reduce the stated size of the state. From what I remember created in the early 90s.
 
I think that is only partly the case. You can of course see them as a 'device', for giving the illusion that the state is smaller. However, I see them more as a device to allow the private sector to plunder the state coffers, whilst appearing to be simply 'fulfilling contracts'. They have failed spectacularly on so many occasions, yet continue to get contracts. If the Govt. was really creating their much vaunted 'market'.. such companies would be allowed to fail.. rather than becoming the cartel that they obviously are. What do you infer from this?
 
I saw it as the transfer of failure from the "State" to the mini state. Actually I think that they gained ascendency during the reign of Blair - so late 90s and early 00s
 
Well.. the least said about Bliar the better, but I really see it as an outcome of Thatcherism.. However, I don't share your assumption that 'The State' failed. Clearly this is not a totally black and white issue, but the general assumption that 'State' = 'Bad and Inefficient' and 'Private' = 'Good and Efficient', is simplistic tripe trotted mostly by those who dislike paying taxes and/or want a slice of the action. Usually both. Sadly, it is also the sort of simplistic argument which is all too easy for the likes of the DM to propagate amongst the hard of thinking, which is why the current bunch of incompetent spivs are still in power.

I
 
Derek Wright said:
I have no love of the Capita etc - they are public service organisations set up to reduce the stated size of the state. From what I remember created in the early 90s.
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Capita are a large, private sector organisation, and a predatory one at that. I should know as I used to deal with them directly when I worked in the public sector.

There are any number of these private sector vultures feeding on the carcass of public services we all once owned. the efficiency gains are dubious but the vast increase in private profit at the expense of the public good is palpable.
 
Mullardman said:
If the decision is to Privatise, all well and good. But this then brings us to the question of Tendering etc. It seems to me that this process in particular is shot through with 'Old Boy Networks' 'Preferred Bidders' 'Vested Interests', lobbying and no doubt corruption on a massive scale.

How do you explain the fact that organisations such as Capita, G4S, Serco et.al keep on gaining lucrative contracts to suck up OUR money, despite having notched up more than a fews pretty spectacular failures over time?

I suspect I know the reason..
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I've been involved in tendering for NHS clinical services for the last thirty years or so, and I've yet to encounter any form of corruption, let alone on a "massive scale". Plenty of incompetence, but not a sniff of anything deliberately underhand. These contracts are subject to intense scrutiny during the course of their term; should any company be so incredibly stupid as to attempt to run such contracts dishonestly, they will not only be breaking the law but they'll never be allowed to tender for another contract. Contracts are awarded on the basis of cost-effectiveness, and costed on the information provided by the NHS Trust, even when the contractor knows (as is generally the case) this information is wildly inaccurate. Since the Tory government, in its wisdom, dismantled NHS Supplies, the purchasing agency for the NHS, Trusts have been responsible for compiling tenders for specialist services of which they have little or no knowledge. A large number of these contracts I've seen are based on out of date ones from donkey's years ago, with so many bits bolted on that NHS Trusts themselves cannot hope to comply with the terms (bearing in mind NHS entities are perfectly free to tender as well as commercial companies).

Tim has provided a very comprehensive and accurate view on this subject, so there's little I can add. I will, however, point out that, like Tim, I really couldn't give a fig who's providing the service, but private companies have been successfully doing so for many years, and there are considerably more small specialist companies involved than the likes of Virgin health etc.
 
We'll agee to differ then
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If you wish, but I'd much prefer it if you could tell me how the Thatcherite/NeoCon/Small State/Privatisation meme pushed by the Tories since 1979, has actually benefitted the country and the population at large?

All I see is: A collapse of public services and an NHS crisis, Local Govt. loaded with ever more responsibility yet fewer resources, a housing/homelessness crisis, a Social Care crisis, low grade employment, zero investment in our manufacturing industries, chaos in education, lack of proper vocational training, rampant deregulation in numerous fields, collapsing infrastructure (poorly maintained roads, streets, public buildings, waterways/ land drainage), a looming energy crisis since we are now 'in hock' to Russia, China and France for our energy sourcing/production, a chaotic rail system, a grossly unfair benefits system. etc., etc. etc...

And the economic benefits of these policies? Zero. Zilch. Nada. Nowt. SFA. The UK is living proof that unfettered Capitalism, is just as bad as Totalitarian Communism. We need a proper Social Democracy in which services are provided as and where needed, not just as a vehicle for profiteering.
 
Mull, I'm sure you're a lovely chap, and a fellow ex-caver, but it's pretty clear, given your rant (which I have some symphany with) you've not enough handle on the subject in hand. Can I respectfully suggest you free yourself from the ideology that's pulled the NHS around from both sides, and consider how the needs of its patients are best served? We've suffered so much from political meddling into heathcare and I can't see an end to it.
 
Personal views as always

The debate about private/public is completely off point as far as I'm concerned (and on a personal basis, I'm am utterly shattered, having spent the past 11 hours at work trying to police the entirely predictable winter crisis in one way or another in the midst of an utterly baroque system for which I am partly responsible, having done my duty as a civil servant to get Lansley's godforsaken Bill through).

It's an artefact of our inherited political culture in many ways. I've been lobbied too, at a national level, and on every single occasion I have been, those doing the lobbying have left empty handed and muttering about legal action.

Mull, I do not disagree with you about the balance of state and private, and especially about the results of a series of failed technocratic experiments about market incentives in a context where they cannot apply.

Nonetheless, and perhaps I didn't put this strongly enough above, the debate over public or private ownership is at best a second order question and at worst a complete distraction - a debate which seems to me to be more about symbolism and personal display than anything else, genuinely felt though the views may be. The point is this; we do not have enough money and are not going to get any under any prospective future Government, of any political colour.

So, what do we do about that?
 
Suffolk Tony said:
Mull, I'm sure you're a lovely chap, and a fellow ex-caver, but it's pretty clear, given your rant (which I have some symphany with) you've not enough handle on the subject in hand. Can I respectfully suggest you free yourself from the ideology that's pulled the NHS around from both sides, and consider how the needs of its patients are best served? We've suffered so much from political meddling into heathcare and I can't see an end to it.
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Tony,
I accept that you've seen no corruption in the delivery of contracts, but I'm afraid I cannot accept that the sheer number of politicians with their snouts in the healthcare trough has no impact on Govt level decisions re: private sector involvement in NHS provision. TBH, I've seen corruption in employment services very close indeed to my own work shortly before I retired from the whole sorry mess created as a direct result of Tory ideology. It is also pretty obvious in many of the contracts dished out to the usual suspects in the wider public sector. I'm afraid I simply cannot see how the pursuit of profit can possibly lead to better health services, without something, somewhere, having to give. In my own experience in another sector, the profit derived from employing less qualified/unqualified staff, who worked effectively to a 'crib sheet' and ticked a lot of boxes, for a lower wage. A few 'bosses' did 'OK' and the Govt. got to save a few quid.

Political meddling? I understand your point in the sense of endless re-organisations etc., but the bottom line is that health care IS political.. and hugely so. Healthcare is a classic example of the 'who gets what?, which in the final analysis is what the political process is all about.

As for the needs of patients...? The population of my village has barely increased in 40 years, yet a dozen Doctors and a similar number of Nurse Practioners etc., struggle to deliver what was delivered formerly by three Docs and a Nurse. Why? Search me... but something has gone very wrong.

As for funding. I think it is pretty evident that it is not keeping up with demand. This is difficult. I accept there is no 'bottomless pit', but there is also more than is being made available and we can't afford for any of it to go to shareholders and profiteers.... that way lies America....

I seem to recall that the original NHS was funded by the 'National Insurance Contribution'. That principle seems to be long abandoned. Maybe that principle needs re-visiting, re-freshing, re-booting and possibly re-costing. But not just to provide profit for privateers.

Mull
 
Tim Jones said:
Personal views as always

The debate about private/public is completely off point as far as I'm concerned (and on a personal basis, I'm am utterly shattered, having spent the past 11 hours at work trying to police the entirely predictable winter crisis in one way or another in the midst of an utterly baroque system for which I am partly responsible, having done my duty as a civil servant to get Lansley's godforsaken Bill through).

It's an artefact of our inherited political culture in many ways. I've been lobbied too, at a national level, and on every single occasion I have been, those doing the lobbying have left empty handed and muttering about legal action.

Mull, I do not disagree with you about the balance of state and private, and especially about the results of a series of failed technocratic experiments about market incentives in a context where they cannot apply.

Nonetheless, and perhaps I didn't put this strongly enough above, the debate over public or private ownership is at best a second order question and at worst a complete distraction - a debate which seems to me to be more about symbolism and personal display than anything else, genuinely felt though the views may be. The point is this; we do not have enough money and are not going to get any under any prospective future Government, of any political colour.

So, what do we do about that?
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Tim, I've already acknowledged your more intimate knowledge of the day to day stuff.. which seems to be taxing you at present...

I welcome your views on the public/private balance as is, but you seem to have abandoned the debate as irrelevant 'going forward'. ( I hate that bloody phrase.. but it works.. in context). Of course, if you are up to the neck simply trying to make the current arrangements work, I can understand that.. but I'm afraid from where I sit it's a long term imperative to 'sort it'.

Clearly, the NHS has not been allocated enough money. This is your operational problem.

Whether the necessary money exists, and could be made available... That is the political argument.

Mull
 
Mullardman said:
As for the needs of patients...? The population of my village has barely increased in 40 years, yet a dozen Doctors and a similar number of Nurse Practioners etc., struggle to deliver what was delivered formerly by three Docs and a Nurse. Why? Search me... but something has gone very wrong.
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Two dozen vs. four: I think you might find three things are true:

1. People who formerly were not seen are seen, and people are in most cases seen more often.
2. The number of 'procedures' done is some multiple of what it was in former times; the number of tests done is at a further order of magnitude.
3. The result of care is only sometimes more favorable than what the profession achieved in past generations, and occasions where actual harm is done have also increased in frequency from in the past.
 
Mullardman said:
Clearly, the NHS has not been allocated enough money. This is your operational problem.

Whether the necessary money exists, and could be made available... That is the political argument.

Mull
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Exactly. The idea Tim puts forward that "The point is this; we do not have enough moneyand are not going to get any under any prospective future Government, of any political colour" is just complete nonsense.

Labour could quite easily provide enough money by upping tax for the rich, the corporations and bringing in the huge amount of tax money that hasn't been paid due to being offshore etc.

Of course those who believe medical services in the UK should be privatised won't admit this. It would go against what they are aiming for. Enter J Hunt.

Jack
 
Tim Jones said:
Nonetheless, and perhaps I didn't put this strongly enough above, the debate over public or private ownership is at best a second order question and at worst a complete distraction - a debate which seems to me to be more about symbolism and personal display than anything else, genuinely felt though the views may be. The point is this; we do not have enough money and are not going to get any under any prospective future Government, of any political colour.
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Lack of money is obviously a fairly fundamental problem, but what makes you so sure of the second part of that statement? The UK spends proportionally less on health care as a percentage of GDP than most of its EU peers (Germany, France, the Netherlands, Sweden, etc.) Why would this be so hard-wired into the system that no future Government will ever be capable of changing this?
 
Sorry to go slightly off topic but a close family member has just had results from a blood test and unfortunately he has 90% chance of either prostate cancer or bone cancer.
He struggles to sleep at night because of pain and has been told he has to wait 2 months for further tests.
Apart from being surprised at how long he has to wait, i think it's incredibly cruel.
 
Sorry to hear this FM. If it's any comfort, as I understand it from a layman's P.O.V., both bone and prostate cancer are pretty slow to progress. In the case of the latter, it is often controlled with drugs. However, nobody should be denied pain relief.
The two month wait seems to be target for some cancers, but It looks like it would all hinge on whther the case was seen as urgent or non urgent.

Lots here: https://www.nhs.uk/NHSEngland/appointment-booking/Pages/nhs-waiting-times.aspx

https://www.england.nhs.uk/statisti...ncer-Waiting-Times-Annual-Report-201617-1.pdf

http://www.christie.nhs.uk/about-us/our-standards/cancer-waiting-times/

Lots more online.
Mull
 
I don't think anyone will depute that the NHS needs more money, and I'm happy to pay more. However, I'm not happy to see more funds just getting absorbed into NHS inefficiency and bureaucracy. Successive governments have poured money into the NHS, and boasted about it, but even leaving aside the wastage, the funds available are always inadequate to meet the soaring demands placed on it.

Mull, you clearly don't believe that any companies who happen to specialise in Healthcare provision should make a profit when operating NHS contracts. That's your view, but then you remove the incentive to innovate, or the means to reward your staff for efficiency. The NHS buys these companies' expertise and expects ongoing improvements and cost saving. They need to be incentivised to provide these things; without incentive, things just stagnate. In an ideal world, the NHS would be a harmonious whole, all parts working together for the love of it, but that's not going to happen. We all need and expect to be rewarded for our efforts, it's a fact of life.
 
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