Right, we'd better get cracking then.
So, how’s FPTP looking to people now?
Same as it ever was. Crap, unrepresentative.
have had mostly zero incentive to look after their own health
Having private insurance doesn't incentivise people either - people in the US are even less healthy than we are. We have TV adverts (and programming) trying to encourage us to be healthy. They have adverts to sell you drugs and promise you that everything will be fine if you just ask your healthcare provider about our drug.
Having private insurance doesn’t incentivise people either
Not wholly no, but having more education and intervention alongside an investment into your own health does seem to; as the Dutch, Germans and Spanish have discovered. There isn't just the NHS and the US model, and TBH there are things that the US model does hugely better than we do, they are incentivized (by losing money) to be integrated. You need to send your patient to the right place at the right time for the right treatment and it needs to work, first time, otherwise you lose money The NHS is (generally) lousy at this. In every CCG there are services operating that are really good, but they aren't signposted, or the local GPs haven't been made aware of, or folk aren't willing to change...
We need, as a population need to move away from the black and white simplistic arguments that currently pass for debate about health, and that needs to start with politicians. It won't be the Tories though, so vote Labour.
@nickc, that all sounds great, changing the way something was done improved outcomes. What you fail to explain is why "privatisation" of the service created better outcomes than if the same changes were made keeping the service in the public sector, and how the requirement for profit over the contract in any way helps improve services.
requirement for profit over the contract in any way helps improve services.
Because there is a limited pot of funds and in the public sector, you rightly can't take the sort of risks that private companies can. If the community service that I describe hadn't worked, then the risk is wholly within the private sector and the public purse remains safe. Do you want to take that risk with public money? We could invest in equipment, training over a number of years that most Trusts either lack capacity planning to do, or aren't incentivised to do because of the to risk public money, or have only enough budget to provide services, not to experiment with new.
You could invest public money into Trusts to grow that capacity, but for years and years now Govts of both colours have beaten the drum of "Front line services" one of the many problems that the NHS has is a lack of capacity to innovate, there just isn't that layer of management anymore that have that insight and drive in co-operation with doctors to drive change.
For profit companies can be made to do good, you just have to set the rules properly.
(Healthcare) Folk in the US aren’t stupid’ that’s why.
Oh, they are. They do one million heart stent operations a year in the US "to stop any problems before they happen"
Of these operations 2% die during the procedure. 20,000 die from something they don't really need, because it's sold to them as a good thing, and makes lots of money for hospitals. Less than half even say they feel better afterwards.
Plus, the number one reason for bankruptcy in the US is medical bills.
It looks a bit stupid from this side of the atlantic
It's not so much private vs public as good management vs bad/no management. As Nick says, the NHS is massively under-managed, despite all the headlines about fat cat NHS managers, and the organisation of primary vs secondary care is preventing the effective sharing of assets.
As far I can see, the scheme described there is simply shifting skills and resources geographically rather than keeping them in a big building in a big town, and streamlining an inefficient referral pathway by cutting out a couple of steps. Patients are seen more quickly, by the right person, rather than seeing an optician, getting told to go to the GP, waiting for a GP appointment, trusting the GP will make the right referral, waiting for a clinic appointment, then waiting for a clinical intervention.
The real question is, what obstacles are there which are preventing this kind of best practice from being the default - and it keeps coming back to the way that these services are organised and funded. The NHS, as he points out, is a mishmash of private contractors, businesses and public-run organisations. There have been attempts to make them consider problems together (primary care trusts, commissioning groups etc).
Hobson's choice - you can either have a single, publically-run system which will probably be bureaucratic and inflexible, or a disconnected mix of public and private which will also probably be bureaucratic and inflexible, neither with a great incentive to change.
or a disconnected mix of public and private which will also probably be bureaucratic and inflexible, neither with a great incentive to change.
No, in order to make the service I describe profitable, we cannot be disconnected, we were incentivised to make sure everyone and their dog knew about it. Same with the incentive to change, what it needs are people who can see profit in risk, and CCGs willing to innovate. There will likely be mistakes, but we cannot afford not to change how we talk about healthcare in this country.
The Tories will want to do that as secondary to making their friends rich. Vote Labour.
They do one million heart stent operations a year in the US
Sure, if you want scarey waste, look up the survival rate of single women over 70 who've had a hip replacement. No healthcare system is perfect.
Nice generalisation. You haven’t got a clue what I do but you carry on thinking
I do have a clue actually cos I read the research. There is a lot of it and most of it says the same thing - there are a set of common behaviours and they quite literally aren't like the rest I us.
There are a lot of people who think like that
They have no **** clue that they are where they are mostly down to luck and privilege, no clue at all.
Nice generalisation. You haven’t got a clue what I do but you carry on thinking that if it makes you feel better.
Hmm. Bit of pot, kettle, black going on there, pal.
If you listen to many older people from northern colliery towns, you’d have thought that the past in these places was some sort of industrial utopia that the Tories destroyed in the 80s
I did listen to them, I had no choice, since they lived in the same house and no, they didn't think it was a Utopia. They did think it was a community in which the people could be proud that they went to work, worked hard, got paid, supported the businesses in their community. Had a sense of purpose, self respect.
When Thatcher closed the pits, including the profitable ones, she did it in a way that caused maximum damage to those people and communities. Parlty because she was pissed at the Unions for 'winning' the last time around. They did precisely nothing to help those people and communities cushion the blow.
Behaviour which you continue to see today.
The level of understanding about how the US health system works is shocking. You do not want to go down that road.
d. Yet in spite of that desperate level of underfunding Labour decided on a wafer thin increase of 3bn.
So do you actually believe that the Tories, who have been slowly strangling the NHS to death, are suddenly going to find all sorts of money for it? Which party, based on its history, is more likely to try and find it properly?
People have spent the last three decades saying the Tory’s are going to privatize the NHS during every election campaign (and at times in between). All that crying wolf means
How is it crying wolf when they have actually been doing it, piece by piece?
So all the other times you said they were going to privatise the NHS they didn’t.
Except for the bits they did. It takes time to sell off a thing as big as the NHS, well the profitable bits at least, in a way the voters don't notice. Judging by you, they've been doing a good job.
So do you actually believe that the Tories, who have been slowly strangling the NHS to death, are suddenly going to find all sorts of money for it?
They'll find as much money for it as the possibly can and then some. But only if it means that large proportions of public funds finds its way into the hands of their mates and paymasters to gouge a profit out of.
Would the average punter even know that the NHS was being privitised? I don't think so. It would be a vote winner amoungst the sheeple - every election campaign huge increase to the NHS budget - they'd lap it up. As long as the NHS remains free at the point of use, I reckon they'll get away with it. Performance indicators and reports can all be manipulated. They won't get away with it if they introduce insurance etc to pay for it though.
Hmm. Bit of pot, kettle, black going on there, pal.
Nothing of the sort. I was referring to actual people that think in a certain way - I did not say all people think that way, i.e. I did not generalise, I was very specific.
there are a set of common behaviours and they quite literally aren’t like the rest I us.
Yes, like I said, you made a massive generalisation.
So this
there are a set of common behaviours and they quite literally aren’t like the rest I us
Is a generalisation (despite it being based on actual research) but this(which is your opinion)
There are a lot of people who think like that
Isn't?
That is some Johnsonian levels of hair splitting. Bravo!
So thanks in advance to the common room for the hard Brexit we’ve got coming and whatever the Tory’s decide to do with that for the next five years
Whereas you've done, what exactly besides sitting on the sidelines making pathetic noises? You've had 4 years since Corbyn became leader and done **** all with it so if anyone is to blame its people like you. Don't point the finger at the people who actually got off their arse and did something, where are your mates in the mighty Tinge party now? Oh that's right, didn't work, gave up and ****ed off. Too hard. I mean, Farage is a total ****er but at least he's a tenacious ****er, those planks had about as much commitment as a teenager that realised they looked really silly after their little flounce. Hence they ****ed off and shut up when they realised nobody was following them and the didn't really have anything new to say.
Get over the colour of the rosette and look for another party, there must be someone out there espousing blairite Liberal policies whilst being upstanding Democrats? Someone surely...
The English are selfish bastards who would rather vote to keep another 1p in their wallets and purses than pay extra to fund public services
Thanks for that. Popping back a couple of pages to report your post.
Did you even bother to read the post preceding it
Yes. Can you expand on what you wrote in such a way that it doesn't come across as anti-english? If you can, I'm all ears, but if you substitute 'english' for a minority of your choice, I'm afraid it doesn't read very well.
People have spent the last three decades saying the Tory’s are going to privatize the NHS during every election campaign (and at times in between). All that crying wolf means
The thing everyone forgets about The Boy Who Cried Wolf is that the sheep got eaten by the wolf.
Weird how all these old boomer ****s vote for the party who are going to **** the NHS - yet they're the ****s who need it the most - they're always in the hospital! I'm a millennial, eating salads, not smoking and exercising my ass off. I never go to the docs!
Every day I walk down the street and am shocked at how, in a first world country, every second person in my goddamn way has some kind of mobility issue. Move it bitch, I'm on the way to the squat rack!
I've seen that @rone
It's too good to be true !
We had Labour canvassers today they were politely pessimistic, lab majority fell from 9000 to 1800 last time but UKIP took 7000 votes & with bxp non existent, they said they'd had some good results in the doorstep today, but you could smell defeat
Shame as local.Labour candidate seems nice & out present Tory NO is a muppet
Did you see this bit too?
https://twitter.com/GrahamLeah1/status/1203768026048466944?s=09
Follow the link inside.
Are you arguing that only a state owned entity can affordably change a lightbulb? Seems unlikely since most of us work for private firms that have their lightbulbs changed without drama.
Or are you arguing that state owned entities are rubbish at negotiating contracts and private hospitals get their bulbs changed at lower cost?
It was nearer £180 to call out the local Serco contractors (known universally throughout the community hospital my wife works as at ‘Bodgit and Scarper’) to get a coat peg put up in their staff room / office.
When she said that was a ridiculous waste of money and she would take a drill in and do it by herself she was told she couldn’t as:
A. She should be treating patients whenever at work (agreed).
B. She would be personally liable if anything went wrong.
They still put coats on the backs of chairs.
As if community hospitals have the time and resource to negotiate contracts for every little thing that comes up, or even an on-call odd job man. Even if they could, a local handyman wouldn’t be able to sign up to ‘SLAs’ saying he or she could be there within two hours or whatever as they have a living to make and can’t sit around waiting to be summoned by the local hospital. It is bollocks to suggest otherwise and the days of each hospital having a full time janitor and odd job man are well gone.
It is massively disingenuous to say otherwise.
So, contracts are negotiated in big blocks that can only be covered by a cartel of large outsourcing firms. They skim a healthy profit (and have to pay their levels of management overhead) and tender low. Net result is shit service and exorbitant charges. It is a racket.
But don’t worry, under Pound Shop Trump we will sell off more and more to private companies. In the round, more money will end up in already wealthy people’s pockets and everything else will get a bit more shit.
Just been in my local and met a local candidate(hot constituency ;-)), who alleged boris is on track to get 40 seat majority.:-(
It was quite hilarious to witness my friend Shahin , tell her he respected her enormously but he would not vote for her. Had I filmed it, it would have gone viral.
My experience of Government contracting is that they are shockingly bad at negotiation - they have very little room for manoeuvre in negotiations / cannot change terms and essentially can have the rings round them. In order to achieve their affordability, loads of stuff gets left out of the core contract and these exceptional items get charged at a premium - so when things go wrong, and they frequently do, they end up paying for it. Also, they change their requirements frequently and late, which again results in expensive changes. Another big issue is frequent changes in Government staff - it's not unusual to be dealing with 2-3 different people over a couple of years and so you end up going back over / re-starting stuff which adds to the time and cost which gets added to the bill.
Whereas you’ve done, what exactly besides sitting on the sidelines making pathetic noises?
I’ll wager he’s done more to get the vote in for Labour than you have, despite being told again and again that he should abandon Labour because he critiques the path and personalities that currently have a hold on the top of the party.
I’ll wager he’s done more to get the vote in for Labour than you have
A few dozen pages back I remember something about designing posters to try to get the youth vote from local colleges out? I'm sure some of the prominent supporters on this thread have done more though.
He's still worse than Hitler though. 🙂
He's not Hitler, he's just a very naughty boy. 🙂
I've attended local Labour party AND Momentum meetings.
They are not full of Stalinist sixth formers or Hatton worshiping hypocrites.
They are attended by people who are genuinely suffering and lots of younger people who want to put a stop to these evil Tory bastards.
No champagne Socialists.
No ulterior motives.
No one wants to lynch Binners for being a bit wet.
Everyone is absolutely desperate, because people are suffering and dying due the selfish bastards who are some of the most prolific posters on this forum.
People who I try to think the best of, people who I'm trying to remain civil with.
Yep, Corbyn can be a completely obtuse old Hector and some of his fellow travellers are poisonous tossers.
So ****ing what?
I don't like the blue coconut abominations in Quality Street, but I don't bleat about it on social media every five minutes and I'll still be buying a tin.
And I'll still vote Labour, because I believe in the intrinsic decency of people.
Rone & Kimbers - re Dr Moderate....both of the poll re-workings make for encouraging reading so I live in hope.
Bit of a counterpoint - talking with a labour-supporting friend who has been door-knocking in a labour held Birmingham constituency which is not a marginal.
His summary - much support for labour but not for Corbyn; his take - Corbyn has too much baggage and is an electoral liability.
We'll find out in 4 days.
molgrips
Subscriber
Every prime minister from WW1 onwards closed mines, by the time Thatcher took over the days of coal were already well in the past.
It wasn’t the fact she closed mines – after all, there’s only so much coal – it was the way that she did it. The miners weren’t stupid, they understood their own business. She pulled the plug on all the mines, viable or otherwise, and made zero effort to instigate a managed shift in industry to give people something else to move on to. The Tower colliery is an example. Closed, then bought out by the workers and continued working for another 30 years. It closed recently because now it finally is out of coal.
She did this she was a Tory and Tories do not give a shit – this is their basic underlying principle. The whole ethos of the Tories is small government, which means letting the markets take care of everything. So yes, in theory, given a large labour force with no jobs they will either move elsewhere or some other company will move in to employ them. This is fine if you treat people as resources, but they aren’t, they are people, and if you just let the market deal with everything they will get totally **** over and their quality of life will suffer. It’s up to you whether or not you think it matters if people are suffering when you could help them.
Molgrips is a decent man and every single word of this is true.
Thatcher's legacy was the disenfranchisement of the working class, the deliberate destruction of communities and the deliberate creation of an 'underclass'.
Destroy people's hope, remove their opportunity for self improvement and then get everyone to blame them for the resulting mess.
Create the cult of the individual, destroy the idea of society and remove the shame associated with venality and greed.
Brexit was our take on the LA riots.
When nothing else is left, when you take away the things that make us human, people need very little encouragement to burn down their own houses.
Great article by Frankie Boyle in yesterday’s Guardian which sums things up perfectly
You’ll be praying they prorogue the next parliament
Love is our only defence. This week please vote tactically to get rid of these vile people who are utterly devoid of even the slightest shred of empathy or compassion. Surely, as a country, we’re better than that?
So this
- there are a set of common behaviours and they quite literally aren’t like the rest I us
Is a generalisation (despite it being based on actual research) but this(which is your opinion)
- There are a lot of people who think like that
Isn’t?
That is some Johnsonian levels of hair splitting. Bravo!
The bit you have missed is that where I say a lot of people think like that it is in the context of the people I speak to and a lot of them thinking like that. So no, it is not a generalisation
You seem to have Johnson levels of understanding. Bravo!
This week please vote tactically to get rid of these vile people who are utterly devoid of even the slightest shred of empathy or compassion.
Please.
This week please vote tactically to get rid of these vile people who are utterly devoid of even the slightest shred of empathy or compassion. Surely, as a country, we’re better than that?
Who are you talking to, people on this thread are well away of what they should do.
The country is full of people who don't have the ability to work out what is best for them or the country and are being fooled again, this time by the 'characterful and funny' prime minister.
One way of countering that is to use the same tactics over the next 5 years ready for the next election. Should be easier because Brexit will be nearing conclusion by then and the fallout can be 100% owned by the Tories, but the first step is to choose a charismatic leader that the majority of people will fall for. Better find that person and get them into a safe Labour seat now.
10 years in power
And still people are going to vote in another 5 years of the Tories 😟
Latest survation poll is not pretty
https://twitter.com/ElectionMapsUK/status/1203827048239771648?s=19
I do wonder if the hard lefties who've spent the last couple of years using the word 'centrist' as an insult will realise that they needed those centrist votes in the end
Blame on both sides Kimbers.
This campaign hasn't been great by Labour (a bit messy & complicated to cut through) but what the **** has BJ got to do before some shit sticks to him?
& I think its not really the "centrists" who've gone to Bojo, its the Shbrexit at all costs brigade.
I was out with a mate on Saturday who's been out canvassing for the labour party. He says its been a pretty grim experience. All he's been hearing on the doorstep is how awful Jeremy Corbyn is.
Our excellent labour MP presently has a majority of 4,500. General consensus from those on the ground, who've been out campaigning, is that he'll be lucky to scrape through with a massively reduced majority, but there's a very good chance our constituency is going to go Tory. Corbyn has gone down like a cup of cold sick on the doorstep. He was an electoral liability 4 years ago, the same again 2 years ago and even more so now.
One seat closer to Johnson getting his majority.
Utterly depressing.
Who knows, maybe the shy-Tory effect has become a shy-Labour effect, polling errors, youth vote....
I've not completely given up hope. I'm also not staying up to watch the results come in.
It will be very useful for the Labour party to have 5 years to reflect on the mistakes they've made without being distracted by being in power.
All he’s been hearing on the doorstep is how awful Jeremy Corbyn is.
Again, which is why the leader is almost more important than anything else. Do those people like the tory polices, do they dislike the Labour policies or is all they care about is that they don't like Corbyn. If so that is pretty shallow but that is how it is.
is how awful Jeremy Corbyn is.
And if it comes to pass that he fails at another election will the Labour party get someone less divisive to lead them?
Blairism was flawed but it got them elected.