| If Tory austerity is bad but Labour’s version is ok.... 20:15 - Sep 12 with 6714 views | BanksterDebtSlave |
....what do we feel about Labour privatisation of the NHS? Just to get ahead of the curve! |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:11 - Sep 13 with 1669 views | bournemouthblue |
| If Tory austerity is bad but Labour’s version is ok.... on 11:26 - Sep 13 by baxterbasics |
You say utter rubbish, but most of what you said doesn't contradict my statement. I said nothing about how hard working the people are, or that they aren't doing their best (although inevitably there will be some that are, some that aren't). We both seem to agree the system is broken.
That needs to be addressed before more money is hosed at it. |
The top down reshuffle from Cameron's government was a disaster |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:19 - Sep 13 with 1648 views | baxterbasics |
| If Tory austerity is bad but Labour’s version is ok.... on 12:11 - Sep 13 by bournemouthblue |
The top down reshuffle from Cameron's government was a disaster |
I don't know enough detail about what they did to agree or disagree, but it wouldn't surprise me. Don't have much confidence that this lot will do better. The more government tries to fix the more they balls up, why do we think politicians can run anything? |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:31 - Sep 13 with 1624 views | DJR |
| If Tory austerity is bad but Labour’s version is ok.... on 11:02 - Sep 13 by Radlett_blue |
Starmer correctly realises that simply throwing more money at the NHS isn't the answer. Despite the derision about the Tories & the NHS, the amount of money spent on it has gone UP in real terms, as have the numbers of staff, but this hasn't been reflected in the numbers of new patients admitted & treated. Starmer has been vague about the details of his reforms, but they are long overdue & at least there is a chance that Labour will be trusted to undertake these reforms as we know the Tories won't be trusted. No other European country tries to operate a similar system, although most of these countries spend more government revenue per head on healthcare than the UK so if we want better public healthcare, we need to raise taxes & Starmer doesn't want to do that. |
The real damage to the NHS was done from 2010-18 when, accounting for population growth and ageing, there was no real terms increase in spending.
Since then spending has increased, but a lot of that was to cope with Covid, and the additional staff employed are hamstrung by a lack of infrastructure in terms of hospitals, scanners etc.
This from Lord Darzi's summary letter.
15. Austerity. The 2010s were the most austere decade since the NHS was founded, with spending growing at around 1 per cent in real terms
Until 2018, spending grew at around 1 per cent a year in real terms, against a long-term average of 3.4 per cent. Adjusted for population growth and changes in age structure, spending virtually flatlined.
In 2018, for the service’s 70th birthday, a more realistic promise was made of a 3.4 per cent a year real terms increase for five years in revenue spending. The promise did not include capital spending, medical training, nor any increase in public health expenditure.
The 2018 funding promise was broken. Spending actually increased at just under 3 per cent a year in real terms between 2019 and 2024 – below both the 2018 promise and the historic rate on which it had been based.
16. Capital. The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending
The result has been crumbling buildings that hit productivity – services were disrupted at 13 hospitals a day in 2022-23. The backlog maintenance bill now stands at more than £11.6 billion and a lack of capital means that there are too many outdated scanners, too little automation, and parts of the NHS are yet to enter the digital era.
Over the past 15 years, many sectors of the economy have been radically reshaped by digital technologies. Yet the NHS is in the foothills of digital transformation. The last decade was a missed opportunity to prepare the NHS for the future and to embrace the technologies that would enable a shift in the model from ‘diagnose and treat’ to ‘predict and prevent’ – a shift I called for in High Quality Care for All, more than 15 years ago.
Some £4.3 billion was raided from capital budgets between 2014-15 and 2018-19 to cover in-year deficits that were themselves caused by unrealistically low spending settlements.
17. On top of that, there is a shortfall of £37 billion of capital investment
These missing billions are what would have been invested if the NHS had matched peer countries’ levels of capital investment in the 2010s. That sum could have prevented the backlog maintenance, modernised technology and equipment, and paid for the 40 new hospitals that were promised but which have yet to materialise. It could have rebuilt or refurbished every GP practice in the country.
Instead, we have crumbling buildings, mental health patients being accommodated in Victoria-era cells infested with vermin with 17 men sharing two showers, and parts of the NHS operating in decrepit portacabins. Twenty per cent of the primary care estate predates the founding of the health service in 1948. [Post edited 13 Sep 2024 12:38]
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| If Tory austerity is bad but Labour’s version is ok.... on 12:35 - Sep 13 with 1600 views | Leaky |
| If Tory austerity is bad but Labour’s version is ok.... on 21:44 - Sep 12 by Nthsuffolkblue |
Neither is OK.
It is a shame that the electorate can't be persuaded that the best way is to tax and invest.
At least, so far, our taxes haven't been thrown away on keeping their donors happy. |
Swap donor's for Unions |  | | |
| If Tory austerity is bad but Labour’s version is ok.... on 12:37 - Sep 13 with 1592 views | DJR |
| If Tory austerity is bad but Labour’s version is ok.... on 12:19 - Sep 13 by baxterbasics |
I don't know enough detail about what they did to agree or disagree, but it wouldn't surprise me. Don't have much confidence that this lot will do better. The more government tries to fix the more they balls up, why do we think politicians can run anything? |
The Lansley reforms, which I actively opposed at the time, were a disaster. Interestingly, I was watching Sky News last night where Tim Montgomerie of Conservative Home said he also opposed them at the time.
Here is what Lord Darzi's summary letter said about them.
21. Management structures and systems. Still reeling from a turbulent decade and the growth in oversight
The Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous. By dissolving the NHS management line, it took a “scorched earth” approach to health reform, the effects of which are still felt to this day. It has taken more than 10 years to get back to a sensible structure. And management capability is still behind where it was in 2011.
Some sanity has been restored by the 2022 Act which put integrated care systems on a statutory basis. This has the makings of a sensible management structure, consisting of a headquarters, seven regions and 42 integrated care boards (ICBs) whose strategy to tackle inequalities, and to improve population health, is set by an Integrated Care Partnership (ICP) that includes local government and the third sector alongside the NHS itself.
Across ICBs, there are differing understanding of their roles and responsibilities, including how far they are responsible for the performance management of providers, and quite how and at what level they should tackle population health. The NHS in England has emulated Wales and Scotland and changed its improvement philosophy from competition to collaboration. The framework of national standards, financial incentives and earned autonomy as part of a mutually reinforcing approach is no longer as effective as it once was, and needs to be reinvigorated.
22. A further effect of the 2012 Act has been a costly and distracting process of almost constant reorganisation of the ‘headquarters’ and ‘regulatory’ functions of the NHS
Although there are ongoing reductions in management spend and headcount numbers continue to fall, some 19,000 people are employed between NHS England and the Department of Health and Social Care (having peaked at 23,000 in 2022). Some 5,200 of the 16,000 employed by NHS England provide shared services to the NHS such as IT infrastructure and 3,500 are in its seven regions. The Department of Health and Social Care has increased in size by more than 50 per cent in the past 10 years, employing fewer than 2,000 people in 2013 compared to more than 3,000 in 2024, as it reabsorbed staff following the abolition of Public Health England.
Accountability is important. But too many people holding people to account, rather than doing the job, can be counterproductive. Regulatory type organisations now employ some 7,000 staff, or 35 per provider trust, having doubled in size over the past 20 years. Taken together, there are nearly 80 people employed in regulatory and headquarters functions for each NHS provider trust. And there are a multitude of other organisations that produce guidance, recommendations and standards. NHS organisations should focus on the patients and communities they serve, but the sheer number of national organisations that can ‘instruct’ the NHS encourages too many to look upwards rather than to those they are there to serve.
The Care Quality Commission – which inspects the NHS – is not fit for purpose, as the recent independent review made clear. Its focus on inputs rather than outcomes has played a major role in driving up the numbers of clinicians in hospitals to unprecedented levels. | | | |
| If Tory austerity is bad but Labour’s version is ok.... on 12:38 - Sep 13 with 1583 views | positivity |
| If Tory austerity is bad but Labour’s version is ok.... on 11:53 - Sep 13 by baxterbasics |
Money *has* been put in, more and more every year, with little benefit. That's the point.
Go find me some health spending charts and figs and show me where the cuts are. There aren't any. |
in real terms, cuts have been made every year, and that's not allowing for an ageing population, which requires real-term rises each year |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:40 - Sep 13 with 1546 views | Leaky |
| If Tory austerity is bad but Labour’s version is ok.... on 11:02 - Sep 13 by Radlett_blue |
Starmer correctly realises that simply throwing more money at the NHS isn't the answer. Despite the derision about the Tories & the NHS, the amount of money spent on it has gone UP in real terms, as have the numbers of staff, but this hasn't been reflected in the numbers of new patients admitted & treated. Starmer has been vague about the details of his reforms, but they are long overdue & at least there is a chance that Labour will be trusted to undertake these reforms as we know the Tories won't be trusted. No other European country tries to operate a similar system, although most of these countries spend more government revenue per head on healthcare than the UK so if we want better public healthcare, we need to raise taxes & Starmer doesn't want to do that. |
The problem is hiring more managers instead of front line staff | | | |
| If Tory austerity is bad but Labour’s version is ok.... on 12:41 - Sep 13 with 1541 views | positivity |
| If Tory austerity is bad but Labour’s version is ok.... on 12:19 - Sep 13 by baxterbasics |
I don't know enough detail about what they did to agree or disagree, but it wouldn't surprise me. Don't have much confidence that this lot will do better. The more government tries to fix the more they balls up, why do we think politicians can run anything? |
politicians set up the nhs in the first place , they're also capable of running things a whole lot better than the private sector, look at the sewage scandal for starters.
however it needs money and expertise, not cuts and not buying inadequate gear and services from your mates which don't work | |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:41 - Sep 13 with 1542 views | itfcjoe |
| If Tory austerity is bad but Labour’s version is ok.... on 12:31 - Sep 13 by DJR |
The real damage to the NHS was done from 2010-18 when, accounting for population growth and ageing, there was no real terms increase in spending.
Since then spending has increased, but a lot of that was to cope with Covid, and the additional staff employed are hamstrung by a lack of infrastructure in terms of hospitals, scanners etc.
This from Lord Darzi's summary letter.
15. Austerity. The 2010s were the most austere decade since the NHS was founded, with spending growing at around 1 per cent in real terms
Until 2018, spending grew at around 1 per cent a year in real terms, against a long-term average of 3.4 per cent. Adjusted for population growth and changes in age structure, spending virtually flatlined.
In 2018, for the service’s 70th birthday, a more realistic promise was made of a 3.4 per cent a year real terms increase for five years in revenue spending. The promise did not include capital spending, medical training, nor any increase in public health expenditure.
The 2018 funding promise was broken. Spending actually increased at just under 3 per cent a year in real terms between 2019 and 2024 – below both the 2018 promise and the historic rate on which it had been based.
16. Capital. The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending
The result has been crumbling buildings that hit productivity – services were disrupted at 13 hospitals a day in 2022-23. The backlog maintenance bill now stands at more than £11.6 billion and a lack of capital means that there are too many outdated scanners, too little automation, and parts of the NHS are yet to enter the digital era.
Over the past 15 years, many sectors of the economy have been radically reshaped by digital technologies. Yet the NHS is in the foothills of digital transformation. The last decade was a missed opportunity to prepare the NHS for the future and to embrace the technologies that would enable a shift in the model from ‘diagnose and treat’ to ‘predict and prevent’ – a shift I called for in High Quality Care for All, more than 15 years ago.
Some £4.3 billion was raided from capital budgets between 2014-15 and 2018-19 to cover in-year deficits that were themselves caused by unrealistically low spending settlements.
17. On top of that, there is a shortfall of £37 billion of capital investment
These missing billions are what would have been invested if the NHS had matched peer countries’ levels of capital investment in the 2010s. That sum could have prevented the backlog maintenance, modernised technology and equipment, and paid for the 40 new hospitals that were promised but which have yet to materialise. It could have rebuilt or refurbished every GP practice in the country.
Instead, we have crumbling buildings, mental health patients being accommodated in Victoria-era cells infested with vermin with 17 men sharing two showers, and parts of the NHS operating in decrepit portacabins. Twenty per cent of the primary care estate predates the founding of the health service in 1948. [Post edited 13 Sep 2024 12:38]
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There is obviously still a lot of New Labour voices involved in the party, I wonder if the Tony Blair Institute will have much input into policy planning as they seem very keen on tech in the healthcare industry and investing in AI and the like.
Not going to happen as a 'reform' though |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:42 - Sep 13 with 1513 views | positivity |
| If Tory austerity is bad but Labour’s version is ok.... on 12:35 - Sep 13 by Leaky |
Swap donor's for Unions |
it's not unions, it's people.
if you don't raise the morale of the doctors and the nurses, they will continue to be driven away in their masses, and the service continues to break down | |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:44 - Sep 13 with 1477 views | positivity |
| If Tory austerity is bad but Labour’s version is ok.... on 12:40 - Sep 13 by Leaky |
The problem is hiring more managers instead of front line staff |
the issue is driving away the front-line staff by chronically underpaying them and then having to spend fortunes on agencies to plug the gaps | |
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| If Tory austerity is bad but Labour’s version is ok.... on 12:57 - Sep 13 with 1428 views | blueasfook |
| If Tory austerity is bad but Labour’s version is ok.... on 11:28 - Sep 13 by baxterbasics |
Some things they do well and some they do not, and geography can play a part too.
I've had some excellent treatment recently with a few issues I had, whereas my wife has had a nightmare experience, which has left her close to panic attacks at the thought of visiting the hospital again. |
Good point, I think it's a bit of a post code lottery as to the quality of service you get. My local hospital is Addenbrookes which I think is one of the better ones. |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 13:01 - Sep 13 with 1406 views | Leaky |
| If Tory austerity is bad but Labour’s version is ok.... on 12:57 - Sep 13 by blueasfook |
Good point, I think it's a bit of a post code lottery as to the quality of service you get. My local hospital is Addenbrookes which I think is one of the better ones. |
Its mine too especially with Papworth next to it | | | |
| If Tory austerity is bad but Labour’s version is ok.... on 13:21 - Sep 13 with 1368 views | blueasfook |
| If Tory austerity is bad but Labour’s version is ok.... on 13:01 - Sep 13 by Leaky |
Its mine too especially with Papworth next to it |
If you need to go in Papworth, usually means you have serious problems with the old ticker. | |
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| If Tory austerity is bad but Labour’s version is ok.... on 13:27 - Sep 13 with 1351 views | blueasfook |
| If Tory austerity is bad but Labour’s version is ok.... on 12:42 - Sep 13 by positivity |
it's not unions, it's people.
if you don't raise the morale of the doctors and the nurses, they will continue to be driven away in their masses, and the service continues to break down |
Same for those poor train drivers struggling to get by on 60k a year. | |
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| If Tory austerity is bad but Labour’s version is ok.... on 13:41 - Sep 13 with 1320 views | giant_stow |
| If Tory austerity is bad but Labour’s version is ok.... on 13:27 - Sep 13 by blueasfook |
Same for those poor train drivers struggling to get by on 60k a year. |
...must........not....up....vote.....
oh bollox.
[Post edited 13 Sep 2024 13:42]
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| If Tory austerity is bad but Labour’s version is ok.... on 13:52 - Sep 13 with 1303 views | positivity |
| If Tory austerity is bad but Labour’s version is ok.... on 13:27 - Sep 13 by blueasfook |
Same for those poor train drivers struggling to get by on 60k a year. |
or the thames water boss struggling to get by on 2.3m a year.
however, neither has much relevance to the nhs discussion... | |
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| If Tory austerity is bad but Labour’s version is ok.... on 14:14 - Sep 13 with 1262 views | Swansea_Blue |
| If Tory austerity is bad but Labour’s version is ok.... on 21:44 - Sep 12 by Nthsuffolkblue |
Neither is OK.
It is a shame that the electorate can't be persuaded that the best way is to tax and invest.
At least, so far, our taxes haven't been thrown away on keeping their donors happy. |
True as a general concept (as long as people see increased taxes leading to better services), but I don’t see why most of us should need to be convinced of higher taxes when there are so many other loopholes being exploited. The tax gap is about £40BN. Avoidance accounts for £1.8BN of that, which would more than cover the winter fuel payments for OAPs. Corporation tax accounts for the largest percentage of the tax gap, some 13.9% in 22/23 (which is £5.6BN).
I imagine it’s fiendishly complicated and the government will never recoup all tax owed, but there must be opportunities to get some of that £40BN a year. And that’s before we start looking at things like raising thresholds.
I saw a clip of Reeves (probably on here) from a decade go talking about scrapping winter fuel payments. It seems it’s purely an idiological move and the black hole hidden from the OBR (which seemingly is correct) has just been used as a pretext. Someone on another thread made the same point.
(And to Bankster and I agree with you - I’m not sure any/many are saying austerity is ok, irrespective of the party imposing it). |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 14:14 - Sep 13 with 1263 views | OldFart71 |
Being in my 70's and privileged to getting free prescriptions although I may upset people approaching 60 years of age I do feel that getting free prescriptions unless diagnosed with qualifying problems that free at 60 bearing in mind that we are now expected to wait until 66,67 or 68 before receiving State pension should be scrapped until a person is able to collect their State pension. Not that I am a believer in people having to wait until 66.67 or 68 before receiving SP. There are probably thousands of young men dossing around because they can't or won't get a job. Apprenticeships should be brought back into industry where trainees work alongside their fully experienced workmates. It's no good stating you want people with experience/ You don't get experience by not doing the job even if overseen by someone. As for the National Health service many are being forced to use life savings to have operations that they desperately need but cannot get. Same with seeing a dentist. I have paid out around £1,700 over the last 3 years for dental work for myself and wife. Don't get me talking about Labour either. Yes the Tories made a hash of everything for 14 years. But Labour won't do any better. Why, because many of them put in ministerial positions, just as the Tories, don't have a clue. | | | |
| If Tory austerity is bad but Labour’s version is ok.... on 14:38 - Sep 13 with 1209 views | The_Flashing_Smile |
| If Tory austerity is bad but Labour’s version is ok.... on 14:14 - Sep 13 by OldFart71 |
Being in my 70's and privileged to getting free prescriptions although I may upset people approaching 60 years of age I do feel that getting free prescriptions unless diagnosed with qualifying problems that free at 60 bearing in mind that we are now expected to wait until 66,67 or 68 before receiving State pension should be scrapped until a person is able to collect their State pension. Not that I am a believer in people having to wait until 66.67 or 68 before receiving SP. There are probably thousands of young men dossing around because they can't or won't get a job. Apprenticeships should be brought back into industry where trainees work alongside their fully experienced workmates. It's no good stating you want people with experience/ You don't get experience by not doing the job even if overseen by someone. As for the National Health service many are being forced to use life savings to have operations that they desperately need but cannot get. Same with seeing a dentist. I have paid out around £1,700 over the last 3 years for dental work for myself and wife. Don't get me talking about Labour either. Yes the Tories made a hash of everything for 14 years. But Labour won't do any better. Why, because many of them put in ministerial positions, just as the Tories, don't have a clue. |
Given they've only been in 2 months, and the Tories were in for 14 years before that, what evidence do you have that many of these new ministers "don't have a clue"? |  |
| Trust the process. Trust Phil. |
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| If Tory austerity is bad but Labour’s version is ok.... on 15:54 - Sep 13 with 1120 views | DJR |
| If Tory austerity is bad but Labour’s version is ok.... on 12:41 - Sep 13 by itfcjoe |
There is obviously still a lot of New Labour voices involved in the party, I wonder if the Tony Blair Institute will have much input into policy planning as they seem very keen on tech in the healthcare industry and investing in AI and the like.
Not going to happen as a 'reform' though |
I am not sure they will use the Blair Institute openly, but it is to be noted that an arch-Blairite (Alan Milburn) appears to have Wes Streeting's ear.
https://www.independent.co.uk/news/uk/wes-streeting-alan-milburn-health-secretar
EDIT: I came across this which suggests a lot of Blarites are involved.
https://www.ft.com/content/9d428e1b-6ed1-4bb9-b889-8f3ffd36e656#:~:text=Sam%20Sh
This includes the following person, if you are not able to open the link.
Sam Sharps, executive director of policy at the Tony Blair Institute for Global Change, holds an influential role as Starmer takes Labour in a more Blairite direction. Sharps, who previously worked at tech giant Apple and as an adviser to telecoms company Vodafone, is heavily involved in TBI’s attempts to find ways to use technology to improve government.
[Post edited 13 Sep 2024 16:19]
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| If Tory austerity is bad but Labour’s version is ok.... on 18:58 - Sep 13 with 1028 views | BanksterDebtSlave |
| If Tory austerity is bad but Labour’s version is ok.... on 12:01 - Sep 13 by victorywilhappen |
'feelings' not facts.
Again. |
Interesting take but I think you'll find it's a question. | |
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| If Tory austerity is bad but Labour’s version is ok.... on 20:07 - Sep 13 with 951 views | Nthsuffolkblue |
| If Tory austerity is bad but Labour’s version is ok.... on 12:35 - Sep 13 by Leaky |
Swap donor's for Unions |
And how much Government spending has gone into the union coffers?
You may not like the link between the unions running political funds that support a party that is likely to look after the interests of their members, but it is a world apart from individual donors being given fraudulent government contracts isn't it?
The figures are also on a completely different scale. £2M from all unions to the Labour Party. £5M from one individual Tory donor last year. https://labourlist.org/2024/08/labour-mps-union-donations-unite-gmb-unison/
https://www.bbc.co.uk/news/uk-politics-65842121 |  |
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| If Tory austerity is bad but Labour’s version is ok.... on 20:54 - Sep 13 with 917 views | The_Flashing_Smile |
Quite. | |
| Trust the process. Trust Phil. |
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| If Tory austerity is bad but Labour’s version is ok.... on 21:58 - Sep 13 with 854 views | Bugs |
| If Tory austerity is bad but Labour’s version is ok.... on 11:53 - Sep 13 by baxterbasics |
Money *has* been put in, more and more every year, with little benefit. That's the point.
Go find me some health spending charts and figs and show me where the cuts are. There aren't any. |
As I'm pretty sure it's already been said on this thread, increases in spending have not kept up with population growth, inflation and the needs of an ageing population.
In 2010 we had one of the most efficient health care systems in the world. .....now we have not. What happened in the last 14 years? Tories. [Post edited 13 Sep 2024 22:01]
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