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Question Time

tiggers said:
Fifth largest employer in the world, it's madness. Needs deconstructing and putting back together properly. The amount of flotsam in the organisation is massive... it's just not sustainable in its current guise.
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Thank you Kate Andrews.
 
Seanm said:
Thank you Kate Andrews.
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Don't get me wrong the last thing I want is to see it go private or whatever, but it genuinely can't go on like it is. In the so called time of austerity it gained 300,000 employees. I have a number of friends and acquaintances who work in it and they to a man (or woman) pretty much agree. I have done two projects for the NHS in the last 3 years and both of them have been unnecessarily painful to say the least. One big issue is the facilities and management of them... an asset model project I was on revealed they haven't until recently even tried to factor basic risk into a lot of their BIM/AIM modelling... it doesn't bode well for future planning.
 
tiggers said:
Don't get me wrong the last thing I want is to see it go private or whatever, but it genuinely can't go on like it is. In the so called time of austerity it gained 300,000 employees. I have a number of friends and acquaintances who work in it and they to a man (or woman) pretty much agree. I have done two projects for the NHS in the last 3 years and both of them have been unnecessarily painful to say the least. One big issue is the facilities and management of them... an asset model project I was on revealed they haven't until recently even tried to factor basic risk into a lot of their BIM/AIM modelling... it doesn't bode well for future planning.
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I don't know, the NHS looks after the health of around 70 million people, from cradle to grave, and health care's a pretty labour intensive business, not especially open to efficiency savings. Seems unsurprising to me that that's an enterprise employing a lot of people. I'm sure there's room for improvement, especially administratively, but the chances of an organisation making serious improvements while it's being systematically de-funded and asset-stripped are close to nil. I mean, that's the unsustainable bit: starving it of cash and hacking the juicy bits off for privateers. I think the priority ought to be to stop actively destroying the organisation. Administrative reform bound to be a lot easier after that.
 
I think the danger is falling into the trap of thinking that anyone who wants to change the NHS wants to privatise or destroy it or whatever happens it will be bad.Yes the Tories want to sell off the good bits, we know that, but there are other paths that I wish other parties would seek to explore rather than just throwing more money at it without any cohesive long term plan. I have lived in the US and in Aus and have seen how their systems work. The US system is alien to me, I think it's pretty awful, but the Australian system has a lot of merit. I am sure if we took a step back we could find ways to improve (as in genuinely improve the service not cut the costs) rather than being scared to touch it.
 
tiggers said:
I think the danger is falling into the trap of thinking that anyone who wants to change the NHS wants to privatise or destroy it or whatever happens it will be bad.Yes the Tories want to sell off the good bits, we know that, but there are other paths that I wish other parties would seek to explore rather than just throwing more money at it without any cohesive long term plan. I have lived in the US and in Aus and have seen how their systems work. The US system is alien to me, I think it's pretty awful, but the Australian system has a lot of merit. I am sure if we took a step back we could find ways to improve (as in genuinely improve the service not cut the costs) rather than being scared to touch it.
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I'm pretty sure if JC got a chance as PM he would try to make it work, not purposely destroy it and then proclaim it was inefficient anyway.
 
tiggers said:
I think the danger is falling into the trap of thinking that anyone who wants to change the NHS wants to privatise or destroy it or whatever happens it will be bad.Yes the Tories want to sell off the good bits, we know that, but there are other paths that I wish other parties would seek to explore rather than just throwing more money at it without any cohesive long term plan. I have lived in the US and in Aus and have seen how their systems work. The US system is alien to me, I think it's pretty awful, but the Australian system has a lot of merit. I am sure if we took a step back we could find ways to improve (as in genuinely improve the service not cut the costs) rather than being scared to touch it.
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The point is that there isn't going to be a solution that doesn't involve throwing money at it, because it's been underfunded for a long time. To insist on reform as a condition of pouring more money in is has become a kind of intuitive common sense thing but it's actually completely unreasonable. I'm not saying you're a right wing ideologue, by the way, but this is definitely a common right wing strategy in all areas and all over the world - IMF "structural reforms" etc. It's like insisting a football club climb to the top of the ...league?... I should steer clear of football analogies...before letting it have any money to buy decent players. I say let's just try funding it at an appropriate level first and then work from there.
 
Seanm said:
The point is that there isn't going to be a solution that doesn't involve throwing money at it, because it's been underfunded for a long time. To insist on reform as a condition of pouring more money in is has become a kind of intuitive common sense thing but it's actually completely unreasonable. I'm not saying you're a right wing ideologue, by the way, but this is definitely a common right wing strategy in all areas and all over the world - IMF "structural reforms" etc. It's like insisting a football club climb to the top of the ...league?... I should steer clear of football analogies...before letting it have any money to buy decent players. I say let's just try funding it at an appropriate level first and then work from there.
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But that has already happened and it doesn't work. Not this lot btw, I'm talking about in the past... we all know the Tories will do nothing to help whatsoever. I totally agree it needs more funds, but I also think it needs a proper long term plan about how to deploy those funds. Just a small and simplified example... all over a certain part of the country (an urban conurbation) there are lots of horrible little NHS offices and surgeries... they are all grossly inefficient in many ways ... yes, that is one of the studies I was involved in. Now the 'innovative' solution we came up with was to get rid of them, but first replace them with hubs that are more efficient, modern and sustainable and then use a funded transport system to move patients to the hubs. We costed this to the minutest detail we could over 20 years and the savings were OK, but the projected service improvements via collaborative working were off the scale and that is what is important. Trouble is no one will look 20 years or even 10 years ahead!
 
The NHS could definitely be more efficient but this needs to be done constructively & with further investment. The problem is that anyone who suggests this is labelled as right wing whereas the other option just seems to pour money in with no real strategy.

Also, politically, you can never close a hospital regardless of whether it's actually is fit for purpose or meets the local requirement.

Anyone who has been admitted into hospital will probably have experienced the endless repetitions of questions as you move through triage. This is very inefficient.
 
Young persons’ QT on BBC 1 now is quite lively. A very shouty panel turning on one another as well as racist piece of shit Farage. A depressing window into the current state of UK politics. It really is the Jeremy Kyle show.

Fascist idiot Farage is now onto climate science denial...
 
Woodface said:
The NHS could definitely be more efficient
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I keep reading this, and there may be truth in it, but it overlooks a couple of very important points.

1) The UK per capita spending on healthcare is about $500-1000 lower than other European countries. The NHS is already quite lightly funded compared to peer countries.
2) Very large organizations, whether public or private, are usually somewhat inefficient and bureaucratic compared to small organizations, but healthcare necessitates large scale, and somewhat conservatively managed organizations. We can't expect it to operate like a startup.

It would probably help somewhat if many in the UK drank less and moved more.
 
Emma Barnett is doing a better job *controlling them all than Fiona Bruce usually does.

*The panelists. The audience members are very well behaved.
 
sean99 said:
I keep reading this, and there may be truth in it, but it overlooks a couple of very important points.

1) The UK per capita spending on healthcare is about $500-1000 lower than other European countries. The NHS is already quite lightly funded compared to peer countries.
2) Very large organizations, whether public or private, are usually somewhat inefficient and bureaucratic compared to small organizations, but healthcare necessitates large scale, and somewhat conservatively managed organizations. We can't expect it to operate like a startup.

It would probably help somewhat if many in the UK drank less and moved more.
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Point one is not really relevant to what I said, our NHS is relatively efficient when per capita spending is taken into account but it could be far better. An example is the woeful IT systems, how has this not been solved? I understand they still use Windows 97 for some applications. As ever suggested improvements are often seen as criticism.

I agree that as a nation we need to be more active & eat less but then you can get accused of fat shaming. Ultimately we all need to take greater care & not expect the NHS to sweep up after us at every turn.
 
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