NHS and official government report.

ronib

MaizieD

I doubt very much if diversity and equality posts take up very much of the NHS budget... What else would you like to see gone?

Use of agency staff
Maybe peg salaries of all senior managers to less than prime minister’s pay?

Would you include the value of the PM's accommodation, cost of a second home, subsidised canteen, travel and the amount he/she can earn in a second job and/or after dinner speeches?

Agency staff can work out cheaper for the NHS than having permanent staff with on-costs for the whole year.

Anything else?

MaizieD

I doubt very much if diversity and equality posts take up very much of the NHS budget... What else would you like to see gone?

Use of agency staff
Maybe peg salaries of all senior managers to less than prime minister’s pay?

I doubt very much if diversity and equality posts take up very much of the NHS budget... What else would you like to see gone?

Growstuff management consultants would charge a small fortune for a report on which roles to cut!

Definitely enhance the number of nurses and doctors therefore increase medical school places, previously vetoed by consultants!
Have greater convalescence beds available with good physio where needed. Ensure very competitive buying options. Improve use of pharmacies.
Cut
Diversity and equality posts. Interminable production of statistics.
I don’t know enough about the management structures to comment on where cuts can be made. Although the head of the Nhs seems to command an exaggerated pay packet.

Bodach

Here's a passage from a speech made in parliament on 22 November 1995 on the state of the NHS. Guess who said it..

"I expect that the House has heard of the little document, which is circulating, about the boat race between the NHS and a Japanese crew. Both sides tried hard to do well, but the Japanese won by a mile. The NHS was very discouraged and set up a consultancy. The consultancy came to the conclusion that the Japanese had eight people rowing and one steering, whereas the NHS had eight people steering and one rowing. The NHS appointed people to look at the problem and decided to reorganise the structure of the team so that there were three steering managers, three assistant steering managers and a director of steering services, and an incentive was offered to the rower to row harder. When the NHS lost a second race, it laid off the rower for poor performance and sold the boat. It gave the money it got from selling the boat to provide higher than average pay awards for the director of steering services. That is what is happening all over the place. There is masses of bureaucracy in the health service and a denial of what people need."

Answer: Tony Benn.

Why is a speech made nearly 30 years ago relevant? Is it because we were nearly at the end of the last long period of Tory rule and the NHS was in a mess then too - over regulation and disinvestment resulting in more managers being needed to try to achieve the unachievable? No, it can’t have been that.

ronib

growstuff

So who would do recruitment, performance management, payroll, organisation of appointments, buy equipment, rotas, building maintenance, IT systems, operate switchboards, record keeping, accounting and all the many other roles I've forgotten?

Those are essential roles

Errmm ... yes ...

So which unessential roles would you abolish?

growstuff

So who would do recruitment, performance management, payroll, organisation of appointments, buy equipment, rotas, building maintenance, IT systems, operate switchboards, record keeping, accounting and all the many other roles I've forgotten?

Those are essential roles

"The NHS in England is a £100 billion-a-year-plus business. It sees 1 million patients every 36 hours, spending nearly £2 billion a week. Aside from the banks, the only companies with a larger turnover in the FTSE 100 are the two global oil giants Shell and BP. If the NHS were a country it would be around the thirtieth largest in the world.

If anything, our analysis seems to suggest that the NHS, particularly given the complexity of health care, is under- rather than over-managed."

From the summary of a King's Fund report

www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers

Here's a passage from a speech made in parliament on 22 November 1995 on the state of the NHS. Guess who said it..

"I expect that the House has heard of the little document, which is circulating, about the boat race between the NHS and a Japanese crew. Both sides tried hard to do well, but the Japanese won by a mile. The NHS was very discouraged and set up a consultancy. The consultancy came to the conclusion that the Japanese had eight people rowing and one steering, whereas the NHS had eight people steering and one rowing. The NHS appointed people to look at the problem and decided to reorganise the structure of the team so that there were three steering managers, three assistant steering managers and a director of steering services, and an incentive was offered to the rower to row harder. When the NHS lost a second race, it laid off the rower for poor performance and sold the boat. It gave the money it got from selling the boat to provide higher than average pay awards for the director of steering services. That is what is happening all over the place. There is masses of bureaucracy in the health service and a denial of what people need."

Answer: Tony Benn.

If anything, the NHS is under-managed.

So who would do recruitment, performance management, payroll, organisation of appointments, buy equipment, rotas, building maintenance, IT systems, operate switchboards, record keeping, accounting and all the many other roles I've forgotten?

Surely Maizie D all countries with health care systems contribute in much the same way to their individual economies?
I can’t understand why the Nhs doesn’t prune non essential personnel and concentrate on more doctors and nurses plus better buildings with improved working conditions. It works for Switzerland why not here?

I know that you know, growstuff, that's why I added a P.S.

But so many people seem to regard the NHS as a big black hole that money just disappears into. They really should be aware of its huge importance to the economy, as well as to the health of the nation.

growstuff

Maizie I know. The point I was trying to make is that healthcare involves something like a sixth of the money the government spends. Therefore, it's not insignificant. It's one of the main roles of any government to decide how money is spent (however the money is created), so healthcare can't ever not be political.

There’s political and political though isn’t there growstuff. There’s the version where the government sets a strategy and budget and believes that the people in charge of the NHS are capable of leading it, so is light touch- and there’s the ‘government knows best’ strategy where impossible targets are set without consultation, the service is micro-managed and reorganised constantly with no discernible benefit and the government blames the service for not achieving what was always impossible.

Maizie I know. The point I was trying to make is that healthcare involves something like a sixth of the money the government spends. Therefore, it's not insignificant. It's one of the main roles of any government to decide how money is spent (however the money is created), so healthcare can't ever not be political.

healthcare is one of the most expensive services provided for the people of the country,

I don't in any way want this to sound critical, growstuff, but I think we must hold on to the fact that the state provided healthcare is also a major foundation of the domestic economy. All the money the state puts into it comes back into the economy (apart, possibly, from profits made by overseas suppliers) and is estimated to stimulate the economy by a 'multiplier' effect of 2.5. And the greater part of the state investment returns to the state by way of taxation. Keeping the NHS short of funds is a desperately bad political choice.

(P.S I know that you know all this, growstuff. It's a general comment, not specifically for you 😁)

kittylester

My husband worked for the NHS for over 50 years so we have experience of lots of different types of government.

The NHS has been used as a political football for years by all shades of government.

The NHS is a political issue. The underlying principles are inextricably linked with political values - whether healthcare should be available for all or only for those who can afford it. One of the key roles of a government is to distribute and tax wealth; healthcare is one of the most expensive services provided for the people of the country, so of course it's political.

Being supported by the government and proper funding would be a good start.

Given that the King’s Fund was set up in 1897 …. I wonder just what direction the Nhs should take to finally be fit for purpose?

Read it in The Guardian this morning, which quotes a government report - but I have recently been looking at Kings Fund and Nuffield reports, and they say much the same thing.

Health….

What report is being quoted please? Is it one of many produced by The King’s Fund?
The King’s Fund is an independent charitable organisation working to improve health and care in England. Their vision is that the best possible heath and care is available to all.

The NHS is, obviously, political. Its creation and continuation is a political decision.

And so is the funding formula which supports it.

The report is clear: it gives Cameron’s decision to reduce the NHS’s annual budget increases from Labour’s 3.6% to an average of just 1.5% as the key reason for the service’s loss of capacity.

The Tories (under Churchill) voted against the NHS 21 times when it was first set up. Thatcher wanted to get rid of it but Ken Clarke advised her that if she did she would lose the next election.

What's happening now is yet another example of "small state".

The NHS was in the best shape it had been for donkeys years after the Labour government.

The Tories have taken away everything we had gained during this past decade.