The experience I've had working with the NHS has been that the managers are generally not competent.

The experience I've had working with in the private sector has been that the managers are generally not competent.

part of the issue is people like me don't get trained to manage

Same in the private sector.

I suppose the biggest difference though is if a business (banks excepted of course) are babdly managed they go bust – the ultimate sanction. Seems to me that poor management in the NHS just leads to more poor management.

The biggest problem with NHS is quality, not quantity. If the emphasis was on better quality care on the front line it would ultimately save money in the long run. I'm speaking from experience here as well, both my son and wife have ended up with multiple trips to hospital because initial diagnosis or treatment was somehow lacking.

There are a lot of nurses in the NHS that are as institutionalised as the managers and about as effective. Until we get over the ridiculous taboo about of we're dealing with people not tins of bins, there will always be an handy get out of jail argument for the ineffiecient and wasteful.

Interresting 50 years after manufacturing industry cottoned on to the lean management concepts (cost reduction, not cost cutting, big difference) health around the world is the latest sector to start using some of the principles.

I've seen "our national debt is rising at 500 million per day" quoted a couple of times here, but I don't think that number's being used right- while googling around finds nothing of any quality using that number, from recollection that's an ongoing trend including the bank bailouts etc, not an ongoing daily event. I'd be interested to see the current numbers

I think the OP's question is possibly a bit naive – it should have been 'do you think the tories will make a better job of running the NHS'.
We currently have a bunch of lying, idealogical freemarketeers who are a bit sensitive to public opinion, with a remote connection to the NHS…
versus a bunch of lying, idealogical freemarketeers who aren't that bothered, and whose only connection is their past attempts at running it down.
To those of you challenging TJ, do you honestly think the tories are going to do a better job? Do you think that the NHS is safe?
I certainly dont.

Ironic that much of the waste in the NHS over the last decade has been generated by those very interests so keen on privatisation (e.g. consultancy parasites, PFI, ISTCs, outsourcing IT, etc). This, of course, then gets blamed on "shoddy public procurement" – whilst those actually responsible for such ****-ups now fill their boots (e.g. the witch Hewitt – advisor to Cinven, and now also at BarCap. How lovely for her). Funny, eh?

To those of you challenging TJ, do you honestly think the tories are going to do a better job? Do you think that the NHS is safe?

I think it's going to be a struggle for anyone, given the state the economy is now in. Whoever runs the NHS is going to need to try and get more bang for the buck, so eliminating inefficiency is likely to be the approach.

But again epicsteve, thats not really answering the question – In amongst their (essentially tory-style) mistakes, Labour HAVE shown some financial commitment.
The Tories on the other hand, would, if they thought they would get away with it, have us all on US-style healthcare, and thats a scary thing for even you high earning middle class folk.

Public sector workers want you to think the Tories will sell off large chunks.

The first thing I would do would be to end the final salary pension scheme for public sector workers.

Whereas normal people believe this STW'ers comment.

so eliminating inefficiency is likely to be the approach

At the risk of sounding like a broken record… from where? Sure, I'd bin PFI agreements, ISTCs, NHS IT etc… but you ain't going to get much in the way of efficiency savings from hospital trusts already running at 101% capacity. Cut spending on acute care & we will be pretty much reduced to running ambulance crews as some kind of inland RNLI service – that is if we don't first inflict some kind of woebegotten PFI lease/hire agreement on the fleet…. And it's all very well chanting platitudes about market efficency – because, strictly speaking, that ain't how they run (better-funded, insurance backed) continental schemes.

I'm not defending the NHS as perfect – but what makes me intensely angry about all this is media/political spin about the workforce. Prior to training as an RN (n.b. I'm back at uni doing something else, so not currently working as such), I spent eight years as an auxiliary nurse, mostly in emergency surgical admissions – where our daily bread was everything from routine appendectomies to multiple gunshot wounds. My old boss was superb – tough, fair, bloody hardworking. I notice that we the taxpayer aren't paying the price for any finanical largess on her part… And I doubt that even Z-11 would find much to criticise regarding the efficiency of NHS employees currently serving in theatre as TA – perhaps the dreaded "producer interest" only kicks in with the day job, eh?

I have no issue with that epicsteve. I just think people are being very naive in thinking that efficiency savings can be anything but marginal.

Myself I'd drop transplant surgery – certainly anything but kidney transplants. years of extra productive life for £ spent is low with heart and liver transplants.

All reproductive medicine as well – no fertility treatments at all.

How about the cognitive enhancers for dementia? Very expensive for not much gain. Herceptin and the like as well. Gone.

These are the sorts of decisions that need to be made if you really want to save money

These are the sorts of decisions that need to be made if you really want to save money

Damned if you do, damned if you don't. As the media have ably demonstrated, on a whole range of "marginal" treatments.

But again epicsteve, thats not really answering the question – In amongst their (essentially tory-style) mistakes, Labour HAVE shown some financial commitment.

It's a difficult choice between a perhaps well meaning but definitely completely incompetent Labour party, or the Tory party who'll cut and damn the consequences.

Sure, I'd bin PFI agreements, ISTCs, NHS IT etc…

That'd be a hell of a start.