Farmer John – that is just utter bobbins you know.

IE

A good example of the “gap”. We are told by NHS staff that focusing specialist procedures (and significant volumes of these) in a small number of hospitals is bad news

Just 100 % wrong – clinicians the country over know that to concentrate specialities in a small number of hospitals is best. Evidence based practice adn this is what the evidence says – its the politicains and the general public who rail against this

There’s almost no focus on improvement, quality or excellence, and that’s entirely down to the NHS Culture in which staff convince themselves the NHS is perfect and can’t be improved.

Wrong – there is a huge focus on this leading to massive change in the way we work to bring best practice to everywhere – this is made much harder by market lead reforms.

Still – what do I know – I have only worked in healthcare both public and private for decades

MF – and it has been explaied to you a part of the reason why it is like this – and also I bet it is a contracted out meal service ( is it?)

I’d be interested in knowing who set the criteria and signed the final contract when contracting out these services.

Wrong – there is a huge focus on this leading to massive change in the way we work to bring best practice to everywhere – this is made much harder by market lead reforms.

How were market led reforms responsible for this?

http://www.bbc.co.uk/news/uk-england-london-18814487

capitalism is a system of oppression and exploitation

No. You do not understand this at all.

Capitalism is simply a system of managing money and labour.

This can be USED to oppress people, but so can pretty much all other systems.

It is not INTRINSICALLY bad for people.

It does have a big intrinsic flaw though, because it relies on continuous growth of production, and that risks destruction of natural resources and the environment. It may be possible to mananage it carefully to avoid that – I hope so.

It may be possible to mananage it carefully to avoid that – I hope so.

Who manages it now? Who should manage it? Who impartially interprets the results? Who should impartially interpret the results?

If we can answer that this afternoon it will be time well spent…

Isn’t STW great? You benefit from the experience of others who have lived in very different environments to yourself. Very interesting to hear that there are pure capitalist economies (I assume that is synonymous with free-market economies) out there and places where one political party uniquely and unequivocally creates and sustains widespread economic prosperity while others do the opposite (albeit excluding the tiny minority of their friends).

All very interesting and in such contrast to the messy world in which I live. One where governments and markets work in conjunction with each other to allocate resources. Sometimes working well together, often not, especially when they step into areas where the other party is better placed to manage!

In my Lewis Carroll-type world, certainties become uncertainties and the world is often turned upside down. So weird things happen such as socialist (sic) governments overseeing the combination of excess and unsustainable growth in a narrow segment of the private sector (finance) and using the proceeds to fund an equally excessive and unsustainable growth in the public sector. At the same time, amazing!

And then, in two of the biggest so-called free market blocks, governments and central bankers conspire to artificially flood markets with liquidity and hold interest rates artificially low in order to compensate for their earlier errors. Then the learned rule-makers create a system that encourages over-concentration of assets, excess leverage and inappropriate pricing of assets by these rapidly growing financial giants. To compound it all governments step in an cajoule economic agents to force feed housing finance on people who cannot afford it – and in foreign lands. What an odd world! Especially when so-called socialist economies do almost exactly the reverse – reduce their role on finance and industry, introduce market reforms and deliver higher levels of economic growth and use all their hard earned savings to bail out their more developed peers. True Alice-in-Wonderland stuff.

The latest installment in this weird parallel world came yesterday when output guestimates came in much worse that people expected. But wait – this data says exactly the opposite to labour markets and tax receipts that tell us that economic activity is recovering. How odd -surely all those new a hard working people are not really that unproductive. There must be something up with this data – so which is Carroll’s “Through the Looking Glass” and which is “Wonderland”? If only anyone knew! 😉

http://www.scottishtimes.com/uk_economy_faces_lehman_type_crisis_says_leading_economist

So, did they achieve the highest patient satisfaction ratings in the survey, or not, then?

Circle are a boutique healthcare provider – running (very) small hotel-ish hospitals that concentrate on tickbox elective procedures in generally fit n’ well patients (albeit usually within blue-light distance of NHS A&E & ITU). That’s what so fugging laughable about their PR efforts – e.g. some recent article-puffery in The Times, in which Circle Bath was compared to Bath RUH as if they were providing the same kind of service. Ali Parsa’s oh-so-timely venture isn’t having to deal with the complex overheads of acute capacity or workforce training/education. So, the NHS gets slagged off – even as it increasingly underpins the profits of sundry “partnered” interests (and Circle’s financial set-up is far-from-straightforward, as befits its backers). In other words, a customer satisfaction survey doesn’t necessarily tell you anything about acuity or casemix – and it’s pretty disingenuous to claim that it reflects clinical reality.

This kind of smoke n’ mirrors stuff really boils my pish – Circle are simply playing a long game.

Farmer_John: nobody, not least frontline grunts, is pretending that the NHS is perfect. But the ConDem reforms are managing to screw up what it can do well – nor will they improve matters for hard pressed services like elderly care. As for hospital catering: largely contracted out, IME. And that doesn’t mean private sector dynamism – it means Serco.

Presses LIKE button

Just as an asside, is it true that the charts on the ends of hospital beds are not standardized? It was on r4 today and I was somewhat amazed that something so important varied across the NHS.

Just as an asside, is it true that the charts on the ends of hospital beds are not standardized? It was on r4 today and I was somewhat amazed that something so important varied across the NHS.

Why would the BBC lie? Hardly an aside either bearing in mind the OP’s position.

something so important

Hmm, I won’t fire up the outrage bus just yet – although that won’t stop the tabloids. It’s true that there is variation in observation monitoring charts (on general wards – & note that there will very different documentation in theatres, ITU etc) & there is a good argument for standardisation – e.g. including urine output as a key component of an EWS (early warning score) system… BUT, tbh, chart parameters are no substitute for clinical acumen & mark 1 eyeballs! You can be sick as a dog, and still score ‘0’!

Proper levels of staffing on general wards would do far more for patient outcomes.

danny boyles a fan of the NHS, take that right wingers!

[video]http://www.youtube.com/watch?v=lEV5AFFcZ-s&feature=related[/video]