Do you believe the NHS is safe in Tory hands after Brexit?

[Tim Jones]

Tim, I'm aware of your alarming familiarity with all this so perhaps you can do what the Lib Dems have failed to do and explain what is so good about the act that it outweighs a) the very obvious bad and b) the opportunity to stop more bad happening. Does it come down too...

Can you explain? Are you claiming (modestly) that this clause forbids the contracting out of services to private firms? Because that will come as as surprise to all the private firms holding NHS contracts.

The use of the alt-right term "virtue signalling" is as ever a major tell here. I note again that it was popularised by one of the UK's premier evangelists for the dismantling of the welfare state, James Bartholomew, and that you were a very early adopter.

Since you're here in your capacity as senior health civil servant can I also take the opportunity to ask you about this:

https://www.theguardian.com/uk-news...o-stop-watchdogs-checks-on-carillion-projects

I am here, as ever, in a strictly personal capacity, so drop the passive aggression.

Your claim Sean, is that the evil Tories want to "privatise" the NHS, intellectually lazy as that word is in this context. Bien-pensant opinion has said the same since I started working in the NHS in 1995. I distinctly remember Alyson Pollock levelling that claim against, er, Frank Dobson in 1999. And yet the NHS goes strangely unprivatised.

If you would like nothing in the NHS to happen by virtue of the private sector, you are going to have a tough time. GPs are effectively private contractors, as is the massive and quite important pharmaceutical industry. The last time I looked at the numbers, the private sector carries out about seven district general hospitals' worth of work. Sometimes they get it wrong. Mind you, sometimes the NHS gets it wrong too.

While I appreciate that in your strange world I am a 'fascist' because I don't share your views or your peculiarly convoluted means of expressing them, there is nothing distinctly right-wing about the point that people often say things on social media to show other people that they are saying them. It is common here and on many other forums, and claiming that anyone who points it up is right-wing is as predictable as it is wrong.

That clause in the Act effectively forbids the NHS from selecting providers on the basis of whether they are from the private or public sectors. If you and those who say the same would really like to do something about an area where provision has been very significantly "privatised", where all of our relatives and eventually we ourselves will go, you might want to apply yourself, as I say, to the knotty problem of how the nation pays for social care.

 

[Seanm]

I am here, as ever, in a strictly personal capacity, so drop the passive aggression.

Your claim Sean, is that the evil Tories want to "privatise" the NHS, intellectually lazy as that word is in this context. Bien-pensant opinion has said the same since I started working in the NHS in 1995. I distinctly remember Alyson Pollock levelling that claim against, er, Frank Dobson in 1999. And yet the NHS goes strangely unprivatised.

If you would like nothing in the NHS to happen by virtue of the private sector, you are going to have a tough time. GPs are effectively private contractors, as is the massive and quite important pharmaceutical industry. The last time I looked at the numbers, the private sector carries out about seven district general hospitals' worth of work. Sometimes they get it wrong. Mind you, sometimes the NHS gets it wrong too.

While I appreciate that in your strange world I am a 'fascist' because I don't share your views or your peculiarly convoluted means of expressing them, there is nothing distinctly right-wing about the point that people often say things on social media to show other people that they are saying them. It is common here and on many other forums, and claiming that anyone who points it up is right-wing is as predictable as it is wrong.

That clause in the Act effectively forbids the NHS from selecting providers on the basis of whether they are from the private or public sectors. If you and those who say the same would really like to do something about an area where provision has been very significantly "privatised", where all of our relatives and eventually we ourselves will go, you might want to apply yourself, as I say, to the knotty problem of how the nation pays for social care.

Tim I'm as awestruck as ever at your ability to accuse others of things you yourself are doing *in that exact post*. But I'm also impressed at your ability to hold contradictory thoughts simultaneously without going mad. The bit in bold. Superb.

The privatisation of the NHS is partial but ongoing, and it is multidimensional - it takes in outsourcing, PFI, wholesale selloffs. I think your problem (and consequently ours) is that your definition of privatisation is excessively narrow. Your clause in no way prevents further privatisation. I don't think even the most brazen privateer would consider admitting to favouring a contractor because they're private sector. They favour them because they're cheaper. And they're cheaper because they focus ruthlessly on cost-cutting. Which is even more unsustainable in this sector than others. So...Carillion (you'll be more familiar with their health care branches than me. Circle was one of them.)

I don't think you're a fascist Tim but your incessant talk of bubbles and virtue signalling, and your willingness to justify e.g. Windrush as the result of the difficulty of balancing the rights of different constituencies (IIRC), and your insistence that we take on board gammony views even if we disagree with them, are clearly all part of a process of accommodation to a very fash-curious Conservative party. It's been interesting to watch. I take it it's not untypical of other One Nation Conservatives close to the establishment.

 

[Dave H.]

...a process of accommodation to a very fash-curious Conservative party.

Ha, fash-curious, what an excellent term.

I had an acquaintance a few years ago (I haven’t spoken to him since) who began referring to himself online as a ‘fashy goy’ almost as if that was some kind of code that the outside world couldn’t crack.

But fash-curious nearly captures a clear vein of Tory psychology over the last few years ‘Crush the saboteurs’, indeed.

 

[Tony L]

Surely it should be ‘fascurious’ without the ‘h’, but great term anyhow. I shall be burping it up in random posts from now on.

 

[eternumviti]

Fash-curious/fascurious. WTF does it mean?

 

[Seeker_UK]

 

[Tim Jones]

Tim I'm as awestruck as ever at your ability to accuse others of things you yourself are doing *in that exact post*. But I'm also impressed at your ability to hold contradictory thoughts simultaneously without going mad. The bit in bold. Superb.

The privatisation of the NHS is partial but ongoing, and it is multidimensional - it takes in outsourcing, PFI, wholesale selloffs. I think your problem (and consequently ours) is that your definition of privatisation is excessively narrow. Your clause in no way prevents further privatisation. I don't think even the most brazen privateer would consider admitting to favouring a contractor because they're private sector. They favour them because they're cheaper. And they're cheaper because they focus ruthlessly on cost-cutting. Which is even more unsustainable in this sector than others. So...Carillion (you'll be more familiar with their health care branches than me. Circle was one of them.)

I don't think you're a fascist Tim but your incessant talk of bubbles and virtue signalling, and your willingness to justify e.g. Windrush as the result of the difficulty of balancing the rights of different constituencies (IIRC), and your insistence that we take on board gammony views even if we disagree with them, are clearly all part of a process of accommodation to a very fash-curious Conservative party. It's been interesting to watch. I take it it's not untypical of other One Nation Conservatives close to the establishment.

I provide you with the specific clause in primary legislation which prevents a SofS via commissioners from "privatising the NHS", and your predictable response is to redefine the question. This rhetoric about "privatisation" is, at root, scaremongering which deliberately confuses the funding basis of the NHS and its Bevanite founding principles on one hand, with the use of private providers on the other.

My talk of bubbles in your case seems well justified. You have a bubble, and you talk to those within it. Any attempt you get you to actually engage with a point is...pointless, because you play to the small crowd who populate the pfm OT crowd.

Speaking of which, and fruitless as I suspect it will be, why don't you deal with the main point here, which is that sorting out social care might actually be more important to patients than, say, the rather pointless obsession with removing the private sector from the NHS?

 

[lazycat]

Speaking of which, and fruitless as I suspect it will be, why don't you deal with the main point here, which is that sorting out social care might actually be more important to patients than, say, the rather pointless obsession with removing the private sector from the NHS?

Speaking as someone who was at the sharp end of all this - staffing in a community hosp - Tim is absolutely right about the provision, or lack of, social care.

Trying to discharge, mostly elderly, patients to home or somewhere more appropriate, is a f***ing nightmare. There is so little provision/money it's no wonder why the Health system is in it's current state.

Although it's reported frequently, people don't realise how bad it is until it's one of their relatives stuck in hospital for want of a service at home, or a bed in a residential/nursing home.

Yes, these services have been privatised - perhaps to their detriment, but the main issue is lack of funds to local councils, local councils who aren't above withdrawing funding at the last minute. And I do mean the very last minute - transport booked and patient already to go.

Should services be brought back in-house? Absolutely, but the Social Care issue is far, far more pressing.

 

[PhilofCas]

Concerning just talking about social care, why split off one element of health and focus on that? I don’t understand, surely every aspect comes under the banner of our National Health Service.

“The founding principles were that services should be comprehensive, universal and free at the point of delivery”.

 

[Fatmarley]

Regardless of whether the NHS will be privatised. We all know it's gradually going downhill, and in the end, that will force people to go private.

 

[ks.234]

My wife works in care, so I am painfully aware of some of the issues. However, the question is about privatisation of the NHS.

On that issue I’m somewhat unconvinced by the argument that a minor clause somewhere in the legislation means that we’re safe from privatisation. It’s a bit like putting a speed limit sign in a hedge in the side of the road and claiming to have stopped the problem of cars speeding.

perhaps a better example is with Academies and Free school legislation. There is undoubtedly many a clause that forbids Academy Trusts and Free Schools making a profit or benefiting disproportionately from public funds, but many do.

 

[Seanm]

I provide you with the specific clause in primary legislation which prevents a SofS via commissioners from "privatising the NHS", and your predictable response is to redefine the question. This rhetoric about "privatisation" is, at root, scaremongering which deliberately confuses the funding basis of the NHS and its Bevanite founding principles on one hand, with the use of private providers on the other.

My talk of bubbles in your case seems well justified. You have a bubble, and you talk to those within it. Any attempt you get you to actually engage with a point is...pointless, because you play to the small crowd who populate the pfm OT crowd.

Speaking of which, and fruitless as I suspect it will be, why don't you deal with the main point here, which is that sorting out social care might actually be more important to patients than, say, the rather pointless obsession with removing the private sector from the NHS?

I didn't redefine the question: I explained to you why that specific clause does not do the thing that you think it does, because privatisation doesn't work the way that you think it does. Of course contracts aren't tendered on the grounds that a company is in the private sector or not: they're tendered on grounds of cost, and that favours the private sector - in a way that is unsustainable. Your clause does absolutely nothing to address this. It's pointless. It barely qualifies as a fig leaf.

I find it very alarming that you don't understand this, given your position! And as for bubbles, what's really the bigger problem here: some random lefty mouthing off on a hi-fi forum, or a senior health civil servant repeating hard right nonsense about privatisation not existing in the NHS, using the language of the alt-right while he's at it? I mean it would be one thing if you said, There are limits to how far privatisation can go, given current rules and political pressures. But to say that it doesn't exist, and that concerns over the insidious way that it operates amount to scaremongering rhetoric...Sorry but it reeks.

As for social care I'm more than happy to talk about it. We need a total re-think of the way that social care is conceived, funded and organised in this country. It needs to be insourced, because care work is unsustainable within a profit-based system. Its value needs to be properly recognised, which will require massive investment in the sector and its professionalisation. Care services need to be co-ordinated with other public services. Work as such needs to be re-organised around care.

Taking the care crisis seriously means completely re-thinking the way that we work and live, and I for one am totally up for that. It suits Labour too and maybe you'd like to compare Labour's proposals on social care to those of the Conservatives. But start another thread, because this one is about the Tories' predatory relationship to the NHS.

 

[Brian]

<snip>

Speaking of which, and fruitless as I suspect it will be, why don't you deal with the main point here, which is that sorting out social care might actually be more important to patients than, say, the rather pointless obsession with removing the private sector from the NHS?

Tim,

I think you need to consider what people mean when they refer to ‘privatisation of the NHS’. Farming out certain services to the private sector may sometimes make sense and is not on its own ‘privatising the NHS’.

Personally, ‘privatising the NHS’ means dismantling the NHS with the aim of setting up a healthcare system that is entirely driven by profit. The US ‘system’ being generally cited. Given the type of individual that becomes a tory MP, this is a justified concern.

Social care seems a mess. Care homes are an example of a specific area of ‘healthcare’ that seems to be operating solely for profit, hence extortionate cost to the sick person and crap wages to those working in it. This is the private sector cashing in on sick people being in a vulnerable position and is what needs to stop but will only become worse under a tory govt, imo.

 

[hifinutt]

it is a fact that the paying customers subsidise the council ones in care homes . bit unfair really . we recently spent time sifting through 52 care establishments in one town down south , once you mention dementia it whittles down to very few and not cheap. Becuase councils pay so little for care then care homes go bust and cannot take the discharges that lazycat was talking about.

Its quite interesting that a recent report of the vaccination uptake problem has highlighted its lack of organisation in the NHS and people unable to get appointments in NHS that has caused the problem

 

[HarryB]

In a nutshell anyone who thinks the NHS is safe in Conservative hands simply hadn’t been paying attention or is a Tory apologist.

 

[Thorn]

I've been told just this week that I have cancer. But for the NHS I'd be cooking crystal meth today.

 

[hifinutt]

sorry to hear that thorn , and yes thank goodness for the NHS with all its failings

 

[chartz]

Bloody crab.
My wife had breast cancer and of course we paid nothing.
What would have happened to us in the States or in Germany I wonder.
Saving the NHS, however imperfect it is, seems like mandatory.

 

[Bob McC]

Tim,

I think you need to consider what people mean when they refer to ‘privatisation of the NHS’. Farming out certain services to the private sector may sometimes make sense and is not on its own ‘privatising the NHS’.

Personally, ‘privatising the NHS’ means dismantling the NHS with the aim of setting up a healthcare system that is entirely driven by profit. The US ‘system’ being generally cited. Given the type of individual that becomes a tory MP, this is a justified concern.

Social care seems a mess. Care homes are an example of a specific area of ‘healthcare’ that seems to be operating solely for profit, hence extortionate cost to the sick person and crap wages to those working in it. This is the private sector cashing in on sick people being in a vulnerable position and is what needs to stop but will only become worse under a tory govt, imo.

how do you square the circle of decent wages for care home staff and reducing cost for people who need care?

 

[lazycat]

how do you square the circle of decent wages for care home staff and reducing cost for people who need care?

It's easy. Folk need to pay more tax. Everyone. Decent services cost money. Don't expect a politician to say that tho'.