[tomtom]

I'd say that pretty much sums up our VC Offwidth...

[Sloper]

I'm sure he's delighting in the wind-up and irony. He must remember I'm a bit too indepedant minded to have joined any political party, am very middle ground politically and have devoted a good amount of time opposing SWP idiocy in my academic union.  I have also never been an Electrical Engineer (but have worked with them).

He is right I was ranting a little bit but that article did annoy me. Its like nearly all promising cheif execs turn into cloned political mice whilst their pay spirals up to encourage reward for (unapparent) leadership. In my area of course its increasingly grey vice-chancellors who's pay is the highest its ever been relative to the average...and before the tory troll pops up again  its not a jealousy or structural thing for me as I dont mind higher pay if it delivers clear success. It looks like a giant con to me that such roles are almost defined as having superior leadership because of the money and when the con merchants say and do stupid stuff of course anger is all too easliy a result.

Nothing wrong with a good rant though is there? 

Whether 'chief executives' and senior managers (particularly in the non profit / public sector) are properly and fairly remunerated is an interesting and valid debtate: what is interesting about what lies at the heart of your rant is what you posit about people, once they reach a certain level, becoming political mice.

There may be something in this, but also it may be that as one rises higher one's vista expands and one can see more: hence the view becoming more consistent with the politicians (as opposed to those at the coal face) is a conseuqence of more and better information and a wider and deeper understanding.

Of course, the counter position is that they're utter cocks cannot be ruled out either.

So are we now agreed, the NHS is not liable for imminent substantial privatisation and that the rate of privatisation has slowed during the course of this government?

[Offwidth]

No we are nothing like in agreement other than on the benefits of a rant. Kings Fund shows government has carried on with the incremental privatisation in the NHS where labour left off and if elected with a majority rather than being held back in coalition,  would have done much more damage, hence my advice don't vote tory. Other reasons (electoral suicide still being the main one) privatisation hasn't gone further include the inability of the private sector to compete that well (look at Circle) and issues around pensions if they want to hive sections off (but how long before they try and do a Royal Mail). On the social care and public health tender side (poor cousins that should have been NHS family) underfunding and privatisation continues apace.

[tomtom]

(Probation service...)

[Sloper]

No we are nothing like in agreement other than on the benefits of a rant. Kings Fund shows government has carried on with the incremental privatisation in the NHS where labour left off and if elected with a majority rather than being held back in coalition,  would have done much more damage, hence my advice don't vote tory. Other reasons (electoral suicide still being the main one) privatisation hasn't gone further include the inability of the private sector to compete that well (look at Circle) and issues around pensions if they want to hive sections off (but how long before they try and do a Royal Mail). On the social care and public health tender side (poor cousins that should have been NHS family) underfunding and privatisation continues apace.

Steve, let's look at the facts:

Privatisation under labour 4.9%
Privatisation under this government 1.2%

Circle failed because of the PFI costs (agreed by Labour) and that icnome is relatively fixed and limtied when demand is fluid and unlimited.

Royal mail is a discretionary service which charges customers directly.  The NHS? hmm can you see the difference?

Social care, I'm note sure about and the reform of the probation service is nonsense on stilts, but none of this has owt to do with the NHS.

[GCW]

What does "privatisation" actually mean with regards to those figures?

[Sloper]

What does "privatisation" actually mean with regards to those figures?

From memory it's payments from central NHS funds to private suppliers of treatment services (as opposed to IT outsourcing, locum staff, drugs, GPs and so on)

[webbo]

 How far does that drill down. As one of the NHS providers in my area is a social enterprise but they commission lots of private providers to deliver their services. What I see on the ground here in the East Riding and Dull is a massive increase in private providers providing Mental Health care. Also if you go to the local Spire hospital (private) it's always overrun with NHS patients as they have referred there in order to meet waiting times.
I am not saying I have any figures to back this up but what I see seems different to those figures you quoted.
Also my own NHS trust has lost its Drug and Alcohol services, Improved access to Psychological therapies services and some of its prison health care services to the private sector under this Goverment.

[GCW]

I would be very surprised if those figures reflect work done by private providers on the behalf of the NHS.

[Offwidth]

Tom,

Those Labour changes happened over 3 terms and not from a zero start position. Also are you 100% sure if you dig down it will pick up all the subcontracted work (eg temp staff agencies, consultancies (esp IT and management), cleaning companiess) or indirect spend commisioned (through Public Health or other such sources). Its all smoke and mirrors hiding more private provision. The conservatives were only stopped from accelerating by the liberals who are liable to be almost invisble after the next election. So I stand by my arguments and genuinely think people should not vote tory if they care about the NHS ....but maybe, given your reputation, I do think you should keep telling people to.

Do you think an old confused person knows which bits of their health care are NHS or not? Having helped with Moff's dad's outcomes after a stroke its been a bloody nightmare getting the various organisations to link even with as knowledgable and tenacious a person as Moff (who is a trained nurse, trained social worker, public health manager with numerous doctor friends).. Its dumb not to coordinate these NHS and social care commissioned services better. A positive aspect is being oh so impressed how, despite all the pressures, the front line NHS staff and carers (on minimum wage) have been largely wonderful.

[Sloper]

Nope, the vast majority happened 2005 - 2010.

GWC, those are the official stats, surprising or not, accurate or not that's what they are.

[slackline]

The truth about cash for referrals. BMJ 2015;350:h396

[drdeath]

The behaviour described in that article is disgraceful...and in my personal experience far more typical of the American or European model...but it's coming here slowly but surely.


D

[mrjonathanr]

I'm a bit too indepedant

Love this. You don't have to go it alone-

Pedants of the world unite!

[GCW]

GWC, those are the official stats, surprising or not, accuurate or not that's what they are.

Blimey Slopper, it's only three letters.
I don't belive the figures. I'm on the inside, and I know they are wrong

[Sloper]

GCW, so you know the figures are wrong but the ONS & etc couldn't possibly be slightly better informed?

Anyway, so what is the current spend in % terms, is it 6.2% or 16%, 33% or what   

[webbo]

My trust used to provide this areas Improved access to Psychological therapies. However under the new contract the provider/ managers of this service had to offer 80% of the service to any qualified provider. So in essence they had to 80% of the contract to the private sector. So an 100% NHS service becomes 80% private.
I suppose an even greater worry is that these services were only really created to get people of benefits and back to work. I guess they could all train to be therapists.

[Sloper]

While I don't know the details of your trust, opening the NHS to non NHS providers doesn't mean that the private tender succeeds.

I'm sure that doctors wouldn't rely on a patient saying 'trust me, I know homeopathy works' or 'I know you tell me I need antibiotics but my priest says they're the devil's work and prayer is far more effective' and I think it's valid to consider the 'I know these stats are wrong' style of comments in the same way.

[webbo]

Having done audits and complied stats. The odd decimal point or nought in the wrong or right place will give you what people want to see. Also why would anyone trust figures trotted out by politicians, that statistical programme on radio 4 has proved that in Parliament when either side quotes figures to prove a point they tend to use different sources so as not to be proved wrong. It's all smoke and mirrors.

[Sloper]

The ONS are independent and reliable.

It's a typical type of bollocks along the lines, stats show what I want = you see I'm right: when the stats show something else and the stats are wrong, made up, manipulated etc 

[Offwidth]

The latest from Roy (evdidence links missing):


No one is asking
News and Comment from Roy Lilley
 
 
We'll call him Bill; tall thin. Widowed. Once in business, now retired. Can't shake off the habit of wearing a pinstriped suit and a military tie.
 
Bill is now one of the 'usual suspects'. On the committee of the CAB, Tory councillor, fundraiser for the hospice, volunteer driver at the Trust and with an interest in anything that will fill the empty days between a game of golf and a hand of bridge. Local charities and local politics are the beneficiaries of the Bills of this world.
 
We had an earnest conversation about the future of the NHS. Bill is numerate and understands the big-blue-bit-of-death. He gets the fact that the party he canvasses for, drops leaflets for and defends until death have made a mess of the NHS. His community involvement lays bare a picture of health and social services, confusion and pressures that his neighbours and friends don't see. He is not keen to amplify.
 
In the middle of a conversation about NHS funding Bill said something that sounded odd... scripted. Like he had learned it. It came out by rote but I got the impression he was uncomfortable saying it.
 
'... we have to deal with the deficit first, a strong economy underpins everything...'
 
On the way home I thought about Bill and what he'd said. It is hard to argue with. Nevertheless, I was cross with myself; I should have challenged him. He was trotting out lines from a Tory Central Office briefing that will be used a million times on the doorstep, up and down the country over the next 90-odd days before the election.
 
Electors will be carpet-bombed with that phrase. Indefatigable, solid, around the kitchen-table logic.  Really?
 
Bill's been conned. He's been brainwashed. There is a world of difference between debt and deficit. At its most basic, debt is how much the government owes. Deficit the difference between what the government takes in in taxes and what it spends. Get it right and there is a surplus; wrong and the government has to borrow to make up the difference and that adds to debt. The rest of us might call it an overdraft.
 
There are three ways to cut the overdraft. Screw government expenditure right down and don't add to the problem. Go hell-for-leather for growth and hope to harvest more taxes and pay it off, or the third; do both.
 
Here are a few random factoids:
Before the financial crisis Labour was borrowing less than the Major government in 1997
The world-wide recession, in 38 countries, was not caused because Labour spent too much on schools and hospitals.
The present government, in the last 5 years, is responsible for £517bn of the trillion+ accumulated public debt compared to the £472bn accrued during 33 years of a Labour led Britain.
There were two years of budget surplus under Mrs T and four under Mr Blair.
UK debt grows at £5,170 per second.
Both debt and borrowing are up.
It is not correct for the Prime Minister to say we are paying down Britain's debt.
The economy was growing at 2.6%pa. The latest figures reveal 0.5%.
The turbulence in the Eurozone and elsewhere may make our goods more expensive and potential customers may have less money to buy from us.
These facts (and I have no doubt you could find facts to challenge the facts and facts to challenge them) are not recited merely to underline the economy still stands in jeopardy.  They are more to demonstrate there is not much happening to sort it out. If austerity is supposed to be fixing the economy, it isn't.
 
The NHS commands about 9.3% of GDP and the EU-15 average is 9.9%. An average that includes countries facing austerity, just like us and some places worse. To ease the pressures Tarzan wants a gargantuan step change in NHS productivity to 3%.  Historically we've managed 1.5%.
 
My guess is, if asked, even people like Bill would pay a bit more in taxes, hypothecated for use by the NHS exclusively, to give it some headroom; but not to pay down debt.
 
The problem is; no one is asking.

------------------------
  Contact Roy - please use this e-address
roy.lilley@nhsmanagers.net
Know something I don't - email me in confidence.

[Sloper]

The usual economic garbage.

Labour ran a defecit in the good times: remember Fast Eddie's NICE decade? This is to be distinuished from the defecit in the Major recession and that this was on the down slope to surplus. As such the relativity of the deficit is irrelevant: a basic summary of Keynesian economics is defecit in recession : surplus in times of good growth.

The recession of course was not caused by a single policy area: what was caused by Labour's policies was that there was so little ammunition available to fight the effects of recession.

The twat doesn't get the accumulation of debt due to deficit.

The muppet doesn't understand that unlike the US who present annualised figures for growth quarterly we present 1/4ly figures 1/4ly.

Hypothecation is generally regarded as being a very bad idea which is why basically no one does it.

So basically a lower VIth examination of the economy and a delta at that.

Why is it I'm not surprised you think it is some revelatory insight?

[Offwidth]

I never said I even agree with what he said, let alone see it as a revelation; its just his latest comment piece with clear relevance to this thread. Maybe its enough that an ex advisor of Maggie and a commentator way more knowledgable than you on the NHS (and linked strongly with the Kings Fund) can think the NHS is as much in trouble as a soft leftie does and that the vote tory line to save the NHS  (you are another Bill) is bunk. Maybe its good enough just that it makes you rant and rave here ...that's entertainment in itself.

PS Stephen Dorrel in the Observer this week was the latest saying the government's health reforms were a major mistake; alongside beds crisis for mentally ill children.

PPS still intending to get round to listing all the money going to non public sector areas that is not included in Kings Fund paper percentages, due to the limitations of what they define as spending in the NHS, but its a big job. I agree the tories didn't and won't likely soon privatise the NHS (as most people understand that) but plenty of extra money not included in those headline percentages goes to private and other non public sources than what did under Labour.This is another recent example of public sector NHS spending in those Kings fund numbers that in is in reality really private.

http://www.theguardian.com/society/2015/feb/03/nhs-doctors-staff-shortages-hospital

[slackline]

rant and rave here ...that's entertainment in itself.

No its not, its tedious, rude and lacks facts to substantiate anything (no not everyone remembers, so post some fucking links to substantiate).  Its rather like the noisy kids I remember from school who made a nuisance of themselves, shouting louder than everyone else for so long that everyone tires of hearing them and ends up ignoring them.  Thankfully this forum has an "Ignore user" feature to facilitate dealing with such nuisances.

[Offwidth]

 I guess not all entertainment meets universal approval. It must entertain Tom as it makes no sense otherwise: he is much more normal and sensible and funny in the flesh. I should be clear I'd much prefer it if he drops this new schizoid cartoon character he hides behind: the wise great uncle with occasional tory torrettes. He was celebrating the fact that wonderful sentences like " fucking fucker's fucking fucked, fuck! " can be said here (and not on UKC) just days ago, without any apparent irony of missing the real differences between the sites. I'm not saying folk shouldn't have fun or be silly or be controversial but manufactured alternate personalities are a bit odd.

Apologies again for no link to Lilly's stuff... maybe someone more literate in these areas can find them somewhere I missed.