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Another £1.3bn contract awarded to a private equity firm.
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"Wonder if the private provider will be charging the NHS VAT?" If they do it will be paid back by the Treasury. | |||
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"When will people accept that money isn't the answer. I really believed Wes Streeting had it sussed but either he didn't actually believe his own rhetoric or he was beaten down by cabinet colleagues. " So what’s the answer? | |||
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"When will people accept that money isn't the answer. I really believed Wes Streeting had it sussed but either he didn't actually believe his own rhetoric or he was beaten down by cabinet colleagues. So what’s the answer?" Wes streeting had ideas that would help. Increase efficiency, ensure the use of funds that were meant for social care are actually spent in social care, get more invested into GP surgery's | |||
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"When will people accept that money isn't the answer. I really believed Wes Streeting had it sussed but either he didn't actually believe his own rhetoric or he was beaten down by cabinet colleagues. So what’s the answer? Wes streeting had ideas that would help. Increase efficiency, ensure the use of funds that were meant for social care are actually spent in social care, get more invested into GP surgery's " I agree, has he moved away from that or is dealing with the current situation also required and what we both agree needs to eventually be the norm is what needs to be worked towards. | |||
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"When will people accept that money isn't the answer. I really believed Wes Streeting had it sussed but either he didn't actually believe his own rhetoric or he was beaten down by cabinet colleagues. So what’s the answer?" Wholesale reform of the entire operating model. Key issues: - the commissioning model is flawed and you have tiers of administration through various trusts that deliver different services - GPs, hospital, ambulance services where ther geohgraphic boundaries don’t overlap which is insane; - The training pipeline is broken. We require nurses to be over-qualified and there are plenty of people who have an ambition to be doctors but the way the training system works too few are admittted and the number of trainig places is less than is needed. The medical colleges have a lot to answer for in terms of this issue, go to other countries and they produce the number of doctors that are needed, here we produce the number the royal colleges say we can have. - Change the tax system that disincentivises senior/experienced consultants from working because both their pay and pensions are raided and penalised when they work beyond a certain point - We are years behind in terms of IT - Make the NHS a 24/7 operation - Devolve clinics into community health centres and away from hospitals - change the funding model and move towards a social insurance model Starters for 10. | |||
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"How does a social insurance model work for those with pre existing conditions?" Heavily loaded premium and/or exclusions. | |||
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"When will people accept that money isn't the answer. I really believed Wes Streeting had it sussed but either he didn't actually believe his own rhetoric or he was beaten down by cabinet colleagues. So what’s the answer? Wholesale reform of the entire operating model. Key issues: - the commissioning model is flawed and you have tiers of administration through various trusts that deliver different services - GPs, hospital, ambulance services where ther geohgraphic boundaries don’t overlap which is insane; - The training pipeline is broken. We require nurses to be over-qualified and there are plenty of people who have an ambition to be doctors but the way the training system works too few are admittted and the number of trainig places is less than is needed. The medical colleges have a lot to answer for in terms of this issue, go to other countries and they produce the number of doctors that are needed, here we produce the number the royal colleges say we can have. - Change the tax system that disincentivises senior/experienced consultants from working because both their pay and pensions are raided and penalised when they work beyond a certain point - We are years behind in terms of IT - Make the NHS a 24/7 operation - Devolve clinics into community health centres and away from hospitals - change the funding model and move towards a social insurance model Starters for 10. " 1. Not sure about where you live but here we get offered treatment in hospitals across Cheshire, Staffordshire and Shropshire. 2. I’m not in a hurry to start going down the route of lowering standards for a not very quick fix. 3. The system was changed by the last government to encourage senior staff to return to work. 4. I agree about IT, the fact I get a letter through the post instead of email/ text is ridiculous and a relatively cheap fix. 5. We don’t have enough staff to cover the shifts now never mind 24/7. 6. I believe that’s what Labour are working towards which would be a good start. 7. As with any insurance model how do deal with those with pre existing conditions. | |||
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"How does a social insurance model work for those with pre existing conditions? Heavily loaded premium and/or exclusions. " 1 in 2 gets cancer, try selling your heavily loaded premium or exclusions to the public when they consider that. | |||
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"I am guilty of this at times… We often think immediately of the healthcare system in the USA which is based on a private health insurance model that has left people destitute and unable to cover the costs of their treatments due to exclusions or thresholds. It is a terrible model unless you are wealthy or have a generous employer. But how do other countries provide their systems. I hear, but do not know for a fact, that healthcare in Germany is excellent but I believe they operate some kind if mixed model." It's a far more efficient healthcare system than the NHS (I have family in Germany). Funding is similar to here, with joint payments by employee and employer (these are mandatory). The difference is that delivery is through private insurance companies rather than the state. The other interesting difference is that you don't have a GP or family doctor per se. The patient does a primary diagnosis themself, and books an appointment with a Specialist, ENT, Dermatology, whatever. No waiting times that I'm aware of. | |||
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" The patient does a primary diagnosis themself" It's the same here. You walk into the doctors surgery and they say "What's the matter?" | |||
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" The patient does a primary diagnosis themself It's the same here. You walk into the doctors surgery and they say "What's the matter?"" Explaining your symptoms to a GP is not self diagnosis. It's explaining your symptoms. The GP will then make a primary diagnosis and refer or otherwise. | |||
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" The patient does a primary diagnosis themself It's the same here. You walk into the doctors surgery and they say "What's the matter?" Explaining your symptoms to a GP is not self diagnosis. It's explaining your symptoms. The GP will then make a primary diagnosis and refer or otherwise. " Sorry I missed off the | |||
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"I am guilty of this at times… We often think immediately of the healthcare system in the USA which is based on a private health insurance model that has left people destitute and unable to cover the costs of their treatments due to exclusions or thresholds. It is a terrible model unless you are wealthy or have a generous employer. But how do other countries provide their systems. I hear, but do not know for a fact, that healthcare in Germany is excellent but I believe they operate some kind if mixed model. It's a far more efficient healthcare system than the NHS (I have family in Germany). Funding is similar to here, with joint payments by employee and employer (these are mandatory). The difference is that delivery is through private insurance companies rather than the state. The other interesting difference is that you don't have a GP or family doctor per se. The patient does a primary diagnosis themself, and books an appointment with a Specialist, ENT, Dermatology, whatever. No waiting times that I'm aware of." Interesting. I believe the cost per capita for healthcare in Germany is higher than the UK right? | |||
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"The key tenet of the NHS is free at the point of delivery. Everyone seems to accept that most primary care, i.e. in GP surgeries, is delivered by private sector partnerships and companies. So where is the issue with employing private sector clinics and hospitals to handle NHS overflow, so long as the patient does not have to pay. It is a symbiotic relationship after all where the more capable NHS hospitals get called upon to put right the mistakes of the private sector made by moonlighting NHS surgeons. " Agreed free is free It’s usually better too , less admin , None of that thing where they write to you saying your appointments been rescheduled but not telling you when and that you will get another letter in a few weeks telling you when and it’s a surprise, you can’t pick the day, If it’s no good for you you wait another few months for another surprise date. In the private sector they use telephones and other modern ways of communicating and tell you the date | |||
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"I am guilty of this at times… We often think immediately of the healthcare system in the USA which is based on a private health insurance model that has left people destitute and unable to cover the costs of their treatments due to exclusions or thresholds. It is a terrible model unless you are wealthy or have a generous employer. But how do other countries provide their systems. I hear, but do not know for a fact, that healthcare in Germany is excellent but I believe they operate some kind if mixed model. It's a far more efficient healthcare system than the NHS (I have family in Germany). Funding is similar to here, with joint payments by employee and employer (these are mandatory). The difference is that delivery is through private insurance companies rather than the state. The other interesting difference is that you don't have a GP or family doctor per se. The patient does a primary diagnosis themself, and books an appointment with a Specialist, ENT, Dermatology, whatever. No waiting times that I'm aware of. Interesting. I believe the cost per capita for healthcare in Germany is higher than the UK right?" Yes, Germany, France, NL have higher expenditure on healthcare per capita than UK. Spain, Italy, Portugal are lower. So UK is in the lower mid-range of European countries. | |||
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"The NHS doesn’t require more money, it needs the money is gets to be spent more wisely. There is a huge amount of waste in the NHS as there is in every area of public sector finances." … and they get ripped off by big pharma | |||
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"The NHS doesn’t require more money, it needs the money is gets to be spent more wisely. There is a huge amount of waste in the NHS as there is in every area of public sector finances. … and they get ripped off by big pharma " Although one of the reasons the pro-privatise the NHS lobby is bankrolled by big pharma is that the NHS currently has price thresholds on drugs that are a LOT LOWER than the USA. | |||
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"I am guilty of this at times… We often think immediately of the healthcare system in the USA which is based on a private health insurance model that has left people destitute and unable to cover the costs of their treatments due to exclusions or thresholds. It is a terrible model unless you are wealthy or have a generous employer. But how do other countries provide their systems. I hear, but do not know for a fact, that healthcare in Germany is excellent but I believe they operate some kind if mixed model." It works well in Spain as well. It’s the model in most of Europe but the hystrionical worshipers at the temple of the NHS present the binary model of what we have v the US and the extrapolate the US model as being representative of the rest of the world to shut down debate on the issue thereby making it politically toxic and ensuring that there’s never any change. | |||
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"I am guilty of this at times… We often think immediately of the healthcare system in the USA which is based on a private health insurance model that has left people destitute and unable to cover the costs of their treatments due to exclusions or thresholds. It is a terrible model unless you are wealthy or have a generous employer. But how do other countries provide their systems. I hear, but do not know for a fact, that healthcare in Germany is excellent but I believe they operate some kind if mixed model. It works well in Spain as well. It’s the model in most of Europe but the hystrionical worshipers at the temple of the NHS present the binary model of what we have v the US and the extrapolate the US model as being representative of the rest of the world to shut down debate on the issue thereby making it politically toxic and ensuring that there’s never any change. " Hmmm we have established that healthcare costs more per capita in some countries. I know a bit about Spain (first hand experience). They put almost all their investment into primary care. It is really good. They invest very little in secondary and follow on care. They expect family to feed and wash patients in hospital, including taking away laundry and bedsheets to be washed. This works in Spain due to multi-generational close knit families (Catholic ethos?) totally expecting to look after relatives. So some of the comparison is apples with (seville) oranges. | |||
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"Unless we understand and acknowledge the influences and reasons why the NHS is broken and no longer fit for purpose, we are simply treading water caught between a rising tide and a low ceiling.." What are the influences and reasons? | |||
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"Unless we understand and acknowledge the influences and reasons why the NHS is broken and no longer fit for purpose, we are simply treading water caught between a rising tide and a low ceiling.. What are the influences and reasons?" what do you think they could be? Are you going to answer with another question, I bet you do | |||
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"Unless we understand and acknowledge the influences and reasons why the NHS is broken and no longer fit for purpose, we are simply treading water caught between a rising tide and a low ceiling.. What are the influences and reasons? what do you think they could be? Are you going to answer with another question, I bet you do "You just did exactly what you said I would do except you did it first! You made a statement: “ Unless we understand and acknowledge the influences and reasons…” So I assumed you must understand so asked what they were. So can you answer? | |||
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"Unless we understand and acknowledge the influences and reasons why the NHS is broken and no longer fit for purpose, we are simply treading water caught between a rising tide and a low ceiling.. What are the influences and reasons? what do you think they could be? Are you going to answer with another question, I bet you do
You just did exactly what you said I would do except you did it first! You made a statement:
“ Unless we understand and acknowledge the influences and reasons…”
So I assumed you must understand so asked what they were.
So can you answer?"No, you’re smart enough to put together a list of influences that cause the NHS to be stretched one way or another, other than simply being the NHS. | |||
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"Unless we understand and acknowledge the influences and reasons why the NHS is broken and no longer fit for purpose, we are simply treading water caught between a rising tide and a low ceiling.. What are the influences and reasons? what do you think they could be? Are you going to answer with another question, I bet you do
You just did exactly what you said I would do except you did it first! You made a statement:
“ Unless we understand and acknowledge the influences and reasons…”
So I assumed you must understand so asked what they were.
So can you answer?
No, you’re smart enough to put together a list of influences that cause the NHS to be stretched one way or another, other than simply being the NHS.
"You don’t know do you!  This pattern is getting really embarrassing now. You make statements that imply you know things but when asked what they are you tell others to tell you! You either actually don’t know, or are being contrary for a laugh, or are trolling.
Seriously, you used to be a good poster, thoughtful interesting posts. Sometimes we agreed sometimes we did not but always a good exchange of thoughts. Lately you have become odd in the style of your posts. Not just with me but others too.
Your style is the obfuscate and imply complexity that the other poster clearly doesn’t understand, implying you have a level of superiority. When asked a straight question, you almost never give a straight answer. Then if challenged on your position several times you puck up your ball and walk away claiming “I’m done here”.
The only conclusion this can lead to is that you post seemingly thought provoking and contrary statements that you are unable to back up.
So when you make a statement like:
“Unless we understand and acknowledge the influences and reasons…”
It is PERFECTLY reasonable for someone to ask you what they are because the implication of your statement is that you know.
It really shouldn't be this hard to have a conversation
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"Unless we understand and acknowledge the influences and reasons why the NHS is broken and no longer fit for purpose, we are simply treading water caught between a rising tide and a low ceiling.. What are the influences and reasons? what do you think they could be? Are you going to answer with another question, I bet you do
You just did exactly what you said I would do except you did it first! You made a statement:
“ Unless we understand and acknowledge the influences and reasons…”
So I assumed you must understand so asked what they were.
So can you answer?
No, you’re smart enough to put together a list of influences that cause the NHS to be stretched one way or another, other than simply being the NHS.
You don’t know do you! This pattern is getting really embarrassing now. You make statements that imply you know things but when asked what they are you tell others to tell you! You either actually don’t know, or are being contrary for a laugh, or are trolling.
Seriously, you used to be a good poster, thoughtful interesting posts. Sometimes we agreed sometimes we did not but always a good exchange of thoughts. Lately you have become odd in the style of your posts. Not just with me but others too.
Your style is the obfuscate and imply complexity that the other poster clearly doesn’t understand, implying you have a level of superiority. When asked a straight question, you almost never give a straight answer. Then if challenged on your position several times you puck up your ball and walk away claiming “I’m done here”.
The only conclusion this can lead to is that you post seemingly thought provoking and contrary statements that you are unable to back up.
So when you make a statement like:
“Unless we understand and acknowledge the influences and reasons…”
It is PERFECTLY reasonable for someone to ask you what they are because the implication of your statement is that you know.
It really shouldn't be this hard to have a conversation
This is the last time I’m going to ask you to stop being so personal, stick to the topic and if you are not getting the reaction you want from me or my posts move on. "I’m just disappointed because I enjoy a considered, informative, thought-provoking, exchange of ideas. So back on topic. Can you explain what you mean by your statement? I want to learn  | |||
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