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Cost of bureaucracy in the NHS 17:39 - Nov 14 with 979 viewsRyorry

Was chatting with my NHS podiatrist yesterday as she tended my feet in a clinic held weekly at my GP's surgery -

1. They (NHS Podiatry Dept. from local hospital 15 miles away) have to pay *rent* to my (NHS) GP's practice for the use of the room!! Anyone like to come up with a rough figure for the cost of the admin on that? Form-filling, accountant's time? etc

2. This room needed new cleats on the wall for each of the two cords for each of the windows' blinds - elfen safety so children don't climb across two desks and hang themselves on the cords ... The cleats were bought and installed, but then their installation had to be confirmed as done. HQ wouldn't accept such confirmation over the phone from the podiatrist, but insisted on sending *two* men in a van from miles away to check... well, maybe each man couldn't count to more than one?!

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Cost of bureaucracy in the NHS on 17:48 - Nov 14 with 807 viewstortoise

The quickest way to save money in the NHS (and teaching for that matter) would be to increase basic pay for all and attract more doctors, nurses and teachers. Then there would not be the reliance on the leeches that are supply agencies... the amount of money lost is astronomical. It’s a complete false economy.
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Cost of bureaucracy in the NHS on 17:51 - Nov 14 with 798 viewsfactual_blue

1. The deranged, Kafkaesque world of the 'internal market'

2. The deranged idiocy of outsourcing: I'd be pretty certain the two men were from whoever has the facilities management contract.

Another example of the madness of the latter. The govt department in which I worked had one of the biggest estate contracts in central government. One office I had thought they were saving money by asking the FMs to move an empty cupboard from one office to another in which it was used. As a result they got charged £700. That was because they'd said what they wanted done, not what the problem they wanted solving. Had they said 'we have a surplus cupboard in Office A', the FMs would have taken it away at no charge as that was included in the contract. Had they then said 'we need a cupboard supplying to Office B', that would have been done at no charge.

Before the whattaboutism starts, that contract was first let in 1996.

Ta neige, Acadie, fait des larmes au soleil
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Cost of bureaucracy in the NHS on 18:04 - Nov 14 with 774 viewsRyorry

Cost of bureaucracy in the NHS on 17:51 - Nov 14 by factual_blue

1. The deranged, Kafkaesque world of the 'internal market'

2. The deranged idiocy of outsourcing: I'd be pretty certain the two men were from whoever has the facilities management contract.

Another example of the madness of the latter. The govt department in which I worked had one of the biggest estate contracts in central government. One office I had thought they were saving money by asking the FMs to move an empty cupboard from one office to another in which it was used. As a result they got charged £700. That was because they'd said what they wanted done, not what the problem they wanted solving. Had they said 'we have a surplus cupboard in Office A', the FMs would have taken it away at no charge as that was included in the contract. Had they then said 'we need a cupboard supplying to Office B', that would have been done at no charge.

Before the whattaboutism starts, that contract was first let in 1996.


1. What genius came up with that concept?!

2. Was the charge because it was a station*ary* cupboard, rather than a station*ery* cupboard which could have been given permission to be mobile?
[Post edited 14 Nov 18:07]

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Cost of bureaucracy in the NHS on 18:07 - Nov 14 with 771 viewsRyorry

Cost of bureaucracy in the NHS on 17:48 - Nov 14 by tortoise

The quickest way to save money in the NHS (and teaching for that matter) would be to increase basic pay for all and attract more doctors, nurses and teachers. Then there would not be the reliance on the leeches that are supply agencies... the amount of money lost is astronomical. It’s a complete false economy.


Totally agree, have been saying same thing for about 3 decades - why are there no sensible, practical people in governments of all hues?! If us mere mortals can see the bleedin obvious ...

Makes you weep.

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Cost of bureaucracy in the NHS on 18:14 - Nov 14 with 768 viewsBlueBadger

The cost of the internal market was conservatively estimated to cost the service at least £4bn a year. That, incidentally is roughly the deficit that the service is running to every year. Couple that to PFI payments(currently costing around £2bn a year) and there's a serious amount of saving to be made.

https://fullfact.org/health/how-much-nhs-market-system-costing/

https://fullfact.org/health/what-nhs-paying-private-finance-initiatives/
[Post edited 14 Nov 21:15]

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Cost of bureaucracy in the NHS on 18:24 - Nov 14 with 746 viewsRyorry

Cost of bureaucracy in the NHS on 18:14 - Nov 14 by BlueBadger

The cost of the internal market was conservatively estimated to cost the service at least £4bn a year. That, incidentally is roughly the deficit that the service is running to every year. Couple that to PFI payments(currently costing around £2bn a year) and there's a serious amount of saving to be made.

https://fullfact.org/health/how-much-nhs-market-system-costing/

https://fullfact.org/health/what-nhs-paying-private-finance-initiatives/
[Post edited 14 Nov 21:15]


Jeez. If some alien with the equivalent of the current average human IQ visited the UK from Mars and saw those figures, would they not think that the governments who set all that up is/are stark staring mad? Must admit I wasn't aware of it (internal market ie), was gob-smacked to find out, and I suspect that goes for the majority of the population.

Who did set such barking mad system up? (Don't be shy now! )

Thanks for the links.

http://media.photobucket.com/image/life%20quote/cdamon/quotes%20nd%20sayings/quote.jpg?o=295
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Cost of bureaucracy in the NHS on 18:26 - Nov 14 with 748 viewsfactual_blue

Cost of bureaucracy in the NHS on 18:04 - Nov 14 by Ryorry

1. What genius came up with that concept?!

2. Was the charge because it was a station*ary* cupboard, rather than a station*ery* cupboard which could have been given permission to be mobile?
[Post edited 14 Nov 18:07]


1. One of the legion of accountants/consultants from KPMG etc who appeared to take over central government in the thatcher/major years

2.

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Cost of bureaucracy in the NHS on 18:31 - Nov 14 with 738 viewsRyorry

Cost of bureaucracy in the NHS on 18:26 - Nov 14 by factual_blue

1. One of the legion of accountants/consultants from KPMG etc who appeared to take over central government in the thatcher/major years

2.


OMG - and none of our genius politicians in the 20-30 years since then, have actually thought to overturn/boot that system out, & replace it with something better?!

http://media.photobucket.com/image/life%20quote/cdamon/quotes%20nd%20sayings/quote.jpg?o=295
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Cost of bureaucracy in the NHS on 18:35 - Nov 14 with 745 viewsBlueBadger

Cost of bureaucracy in the NHS on 18:24 - Nov 14 by Ryorry

Jeez. If some alien with the equivalent of the current average human IQ visited the UK from Mars and saw those figures, would they not think that the governments who set all that up is/are stark staring mad? Must admit I wasn't aware of it (internal market ie), was gob-smacked to find out, and I suspect that goes for the majority of the population.

Who did set such barking mad system up? (Don't be shy now! )

Thanks for the links.


It was set up in the 1980s by the Thatcher government, fiddled about with by New Labour between 97 and 2010 and then 'reformed' and expanded from 2017 onwards.
The waste involved is astronomical.
You've only got to look at the experience here in Suffolk we had with community nursing services. Serco came in, grossly undercut the NHS bidder to the tune of £10M and then, no the surprise of no-one who'd been actually watching developments, promptly announced that they were cutting 1 in 10 staff ACROSS THE BOARD. The net result of this was that complaints went up, quality of care went down, yet more staff members left due to workloads which were not only increasing but becoming increasingly unrealistic, closure of district nursing offices(meaning remaining staff were increasingly isolated leading to burn-out of junior staff) and a cack-handed implementation of caseload allocation which only worked intermittently and was administered by untrained personnel working out of Ipswich(not really helpful if you're working in say, Clare) and the hospital trust were ultimately left to pick up the pieces, at far greater cost.

Looking nationally, there's the NHs Direct/111 farce. NHS Direct, a service led by experienced nurses became known as 'NHS Redirect' in A&E's due to their effectiveness in relieving pressure on emergency Departments by ensuring that the worried well and the 'should go to their GP' brigades were, wherever possible, directed away from hospital services. It was phased out by 2014 by the Toey led coalition who replaced it with 111, which has aa qualified to non qualified staff ration of 1 to 10, because it would deliver 'value for money'. This means you're pretty likely to end up speaking to a script monkey. Obviously if someone is working to a script, the safety margins have to be much, much tighter. The result? Increased and ever-increasing A&E attendances.
[Post edited 15 Nov 9:04]

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Cost of bureaucracy in the NHS on 18:40 - Nov 14 with 728 viewsfactual_blue

Cost of bureaucracy in the NHS on 18:31 - Nov 14 by Ryorry

OMG - and none of our genius politicians in the 20-30 years since then, have actually thought to overturn/boot that system out, & replace it with something better?!


Mr Corbyn has.


Many of the contracts are long-term - 20-25 years - with hefty early termination clauses. The trick is to stop the company involved wanting the contract and get them to walk away.

Ta neige, Acadie, fait des larmes au soleil
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1
Cost of bureaucracy in the NHS on 18:45 - Nov 14 with 720 viewsfactual_blue

Cost of bureaucracy in the NHS on 18:40 - Nov 14 by factual_blue

Mr Corbyn has.


Many of the contracts are long-term - 20-25 years - with hefty early termination clauses. The trick is to stop the company involved wanting the contract and get them to walk away.


Also, there were some nifty accounting tricks involved about moving capital expenditure into operating costs, but I think the accounting bodies have - or are going to - stop that.

Although whether the public sector should actually produce financial accounts is another matter. I remember over twenty years ago an MOD accountant telling me they were having trouble establishing a fair value for some of their assets.

'Like what?', I asked.

'Canada', he replied, 'we own a lot of it.'

Ta neige, Acadie, fait des larmes au soleil
Poll: How old is Phil today
Blog: [Blog] The Shape We're In

1
Cost of bureaucracy in the NHS on 18:51 - Nov 14 with 710 viewsRyorry

Cost of bureaucracy in the NHS on 18:35 - Nov 14 by BlueBadger

It was set up in the 1980s by the Thatcher government, fiddled about with by New Labour between 97 and 2010 and then 'reformed' and expanded from 2017 onwards.
The waste involved is astronomical.
You've only got to look at the experience here in Suffolk we had with community nursing services. Serco came in, grossly undercut the NHS bidder to the tune of £10M and then, no the surprise of no-one who'd been actually watching developments, promptly announced that they were cutting 1 in 10 staff ACROSS THE BOARD. The net result of this was that complaints went up, quality of care went down, yet more staff members left due to workloads which were not only increasing but becoming increasingly unrealistic, closure of district nursing offices(meaning remaining staff were increasingly isolated leading to burn-out of junior staff) and a cack-handed implementation of caseload allocation which only worked intermittently and was administered by untrained personnel working out of Ipswich(not really helpful if you're working in say, Clare) and the hospital trust were ultimately left to pick up the pieces, at far greater cost.

Looking nationally, there's the NHs Direct/111 farce. NHS Direct, a service led by experienced nurses became known as 'NHS Redirect' in A&E's due to their effectiveness in relieving pressure on emergency Departments by ensuring that the worried well and the 'should go to their GP' brigades were, wherever possible, directed away from hospital services. It was phased out by 2014 by the Toey led coalition who replaced it with 111, which has aa qualified to non qualified staff ration of 1 to 10, because it would deliver 'value for money'. This means you're pretty likely to end up speaking to a script monkey. Obviously if someone is working to a script, the safety margins have to be much, much tighter. The result? Increased and ever-increasing A&E attendances.
[Post edited 15 Nov 9:04]


What a horror story in every way - if anyone had actually set out to try and create a plan that would be so damaging and destructive, I doubt it could have been more successful.

I'd have expected Thatcher to be at least somewhat intelligent in imagining the likely outcome of such a possible scheme, so have to put it down to greed, power, and desire for more power by the tories.

Does also highlight another failure by Blair - I'd have expected him to have got to grips with that issue & sorted it - he had a clear enough majority, for a long enough time to have done so? I'd have thought.

Just an absolute tragedy really, and baffling that it's allowed to carry on unregarded.

Appreciate the explan Badger, thanks.
[Post edited 14 Nov 18:57]

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Cost of bureaucracy in the NHS on 18:57 - Nov 14 with 694 viewsRyorry

Cost of bureaucracy in the NHS on 18:40 - Nov 14 by factual_blue

Mr Corbyn has.


Many of the contracts are long-term - 20-25 years - with hefty early termination clauses. The trick is to stop the company involved wanting the contract and get them to walk away.


Ask 100 people on here whether they'd give 20-25 year contracts on *anything* (except maybe a mortgage) and I suspect 90% would come back with the view that that would be bonkers!

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Cost of bureaucracy in the NHS on 19:10 - Nov 14 with 679 viewsBasuco

Cost of bureaucracy in the NHS on 18:51 - Nov 14 by Ryorry

What a horror story in every way - if anyone had actually set out to try and create a plan that would be so damaging and destructive, I doubt it could have been more successful.

I'd have expected Thatcher to be at least somewhat intelligent in imagining the likely outcome of such a possible scheme, so have to put it down to greed, power, and desire for more power by the tories.

Does also highlight another failure by Blair - I'd have expected him to have got to grips with that issue & sorted it - he had a clear enough majority, for a long enough time to have done so? I'd have thought.

Just an absolute tragedy really, and baffling that it's allowed to carry on unregarded.

Appreciate the explan Badger, thanks.
[Post edited 14 Nov 18:57]


I would add to that, in the mid 70's I was listening to a radio program looking at the percentage of health service budgets that was spent on administration around the World. The USA was around 28%, France 10%, Germany 6% and then the UK 4%. I wonder what it is today compared to these Countries?

Super Mick McCarthy, COYB's

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Cost of bureaucracy in the NHS on 19:17 - Nov 14 with 667 viewsLeoMuff

Cost of bureaucracy in the NHS on 18:14 - Nov 14 by BlueBadger

The cost of the internal market was conservatively estimated to cost the service at least £4bn a year. That, incidentally is roughly the deficit that the service is running to every year. Couple that to PFI payments(currently costing around £2bn a year) and there's a serious amount of saving to be made.

https://fullfact.org/health/how-much-nhs-market-system-costing/

https://fullfact.org/health/what-nhs-paying-private-finance-initiatives/
[Post edited 14 Nov 21:15]


The added irony being you can’t even get a biro on a ward now if your pen runs out due to budget cutting

The only Muff in Town.

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Cost of bureaucracy in the NHS on 19:25 - Nov 14 with 662 viewsBasuco

Cost of bureaucracy in the NHS on 18:07 - Nov 14 by Ryorry

Totally agree, have been saying same thing for about 3 decades - why are there no sensible, practical people in governments of all hues?! If us mere mortals can see the bleedin obvious ...

Makes you weep.


My daughter benefited from this madness when at the madhouse that was Hinchingbrooke hospital when run by Circle, as a locum working under an umbrella company she effectively jumped nearly two pay grades in her take home pay. The agency she worked for were making a profit and she was earning much more than if permanently employed. There was no budget for more staff but there was for locum's. The fact the place was an absolute shambles and only the very good staff there at the time prevented a major catastrophe is beside the point.

Super Mick McCarthy, COYB's

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Cost of bureaucracy in the NHS on 19:31 - Nov 14 with 657 viewsBasuco

Cost of bureaucracy in the NHS on 18:26 - Nov 14 by factual_blue

1. One of the legion of accountants/consultants from KPMG etc who appeared to take over central government in the thatcher/major years

2.


McKinsey took £60 million of NHS money last year for cost cutting consultancy fees, topped up by the fact they get 20% of any savings they can find in addition to the up front fee.

Super Mick McCarthy, COYB's

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Cost of bureaucracy in the NHS on 21:01 - Nov 14 with 584 viewsTractorWood

It's the 5th biggest employer in the world and has the budget of medium sized country. We either need to fund the daylights out of it through more tax or accept that it can't be the thing everyone wants it to be and scale it back to an effective service that works for the majority of cases. At the moment it's this underfunded, inefficient monster but everyone expects a gold plated service.
[Post edited 14 Nov 21:05]

I know that was then, but it could be again..
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Cost of bureaucracy in the NHS on 21:19 - Nov 14 with 571 viewsfactual_blue

Cost of bureaucracy in the NHS on 21:01 - Nov 14 by TractorWood

It's the 5th biggest employer in the world and has the budget of medium sized country. We either need to fund the daylights out of it through more tax or accept that it can't be the thing everyone wants it to be and scale it back to an effective service that works for the majority of cases. At the moment it's this underfunded, inefficient monster but everyone expects a gold plated service.
[Post edited 14 Nov 21:05]


The UK is devoting a diminishing proportion of GDP in health and is now a lowly 13th out of the original 15 EU members in terms of investment.

Healthcare spending in 2016 of £185 billion equates to the GDP of somewhere like Palau in the Pacific Ocean, one of the lowest 3-4 GDPs in the world.

The UK's GDP is about £2.3 trillion dollars.
[Post edited 14 Nov 21:27]

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Cost of bureaucracy in the NHS on 21:39 - Nov 14 with 539 viewsTractorWood

Cost of bureaucracy in the NHS on 21:19 - Nov 14 by factual_blue

The UK is devoting a diminishing proportion of GDP in health and is now a lowly 13th out of the original 15 EU members in terms of investment.

Healthcare spending in 2016 of £185 billion equates to the GDP of somewhere like Palau in the Pacific Ocean, one of the lowest 3-4 GDPs in the world.

The UK's GDP is about £2.3 trillion dollars.
[Post edited 14 Nov 21:27]


Not incorrect but disingenuous as that data includes private healthcare investment too so your not comparing like for like. Also not all healthcare in the EU is free at the point of use, so again I'm not saying the headline is incorrect but comparing macro investment is inherently tough.

I know that was then, but it could be again..
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Cost of bureaucracy in the NHS on 11:07 - Nov 15 with 363 viewsNo9

Cost of bureaucracy in the NHS on 18:31 - Nov 14 by Ryorry

OMG - and none of our genius politicians in the 20-30 years since then, have actually thought to overturn/boot that system out, & replace it with something better?!


Do a search to see how many tory MP's have 'interests' in 'Priate' health and associated schemes - that tells you why nothing gets done= a gravy train which allows them you to vote on legislation that makes them richer
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Cost of bureaucracy in the NHS on 11:57 - Nov 15 with 338 viewsRyorry

Cost of bureaucracy in the NHS on 19:31 - Nov 14 by Basuco

McKinsey took £60 million of NHS money last year for cost cutting consultancy fees, topped up by the fact they get 20% of any savings they can find in addition to the up front fee.



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Cost of bureaucracy in the NHS on 12:00 - Nov 15 with 336 viewsRyorry

Cost of bureaucracy in the NHS on 11:07 - Nov 15 by No9

Do a search to see how many tory MP's have 'interests' in 'Priate' health and associated schemes - that tells you why nothing gets done= a gravy train which allows them you to vote on legislation that makes them richer


Ah - a bit like their vested interests in the oil & gas industries/fracking then, instead of following the intelligent & responsible route of investing in renewables (which could be a major contributor to our GDP and trade, quite apart from the good environmental reasons for doing so).

http://media.photobucket.com/image/life%20quote/cdamon/quotes%20nd%20sayings/quote.jpg?o=295
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Cost of bureaucracy in the NHS on 12:07 - Nov 15 with 329 viewsNo9

Cost of bureaucracy in the NHS on 12:00 - Nov 15 by Ryorry

Ah - a bit like their vested interests in the oil & gas industries/fracking then, instead of following the intelligent & responsible route of investing in renewables (which could be a major contributor to our GDP and trade, quite apart from the good environmental reasons for doing so).


That is a whole subject that needs to be investigated by more than parliamentary officials.
There are cases of 'vested interests' being overlooked and cases of potential misuse of public funds
Both will be swept uinder the carpet while we have the low quality standrds that currently exist in public life.
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Cost of bureaucracy in the NHS on 12:12 - Nov 15 with 321 viewsNo9

Have you read this?

https://www.theguardian.com/commentisfree/2017/nov/13/conservative-governments-k

These are things we the public should be demanding get investigated
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