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[b]Project[/b] re the physio cost issue - You'd think so - especially when another hospital they ran was a "National Exemplar Site" for physio access targets. But because GPs were not allowed to refer anywhere else, or to private providers, they had no incentive to change and develop an efficient system, and because sections of the budget were not hypothecated to the departments which had generated the income the physio dept had no money to do it...
In very many ways the way the NHS is organised rewards failure, not efficiency. The lack of clear hypothecation and budget streams means money rarely gets thrown at efficient departments, it gets thrown at the inefficient problem departments. And often that is as much to do with pig-headed Drs as it is down to managers.
The big costs in running a hospital are staff. Not premises. Using them efficiently would be a start. And private providers have fixed costs too.
Project re the physio cost issue - You'd think so - especially when another hospital they ran was a "National Exemplar Site" for physio access targets. But because GPs were not allowed to refer anywhere else, or to private providers, they had no incentive to change and develop an efficient system, and because sections of the budget were not hypothecated to the departments which had generated the income the physio dept had no money to do it...
Havent the faintest what the above means, and probably no one else who you talk to does............
Stoatsbrother. Look you continue to misconstrue and are unwilling to hear any criticism. This is not a simple continuation of previous arrangements - its a fundamental reorganisation.
This is driven my the tories links with private health companies and is designed to give them access to skim of the parts they can make profit from.
I ask again - what experience do you or any other GP have of running and organising large intitutions with hundreds or thousands of staff.
Project 😳
Ok... If you have only one LBS, don't expect cheap prices. If this staff don't get any incentive to work well, don't expect good service.
[b]TJ[/b] Tony Blair was being advised on Health Service reform by a nice bloke called Simon Stevens many many years ago. Google him and who he is now if you think things are really any different now. Or look at the Labour imposition of Capital Charges to "level the playing field" so the private sector to compete. Or the Labour impostion of DTCs? The trouble is you make it a simple political issue, foist on the UK by a political party which has no legitimacy in Scotland. Actually it is a continuation of what has been happening for years. And Labour (of whichI I was once a member) are just as bad. And some sort of competition and willingness to let some NHS organisations fail is necessary to get any change.
Look you continue to misconstrue and are unwilling to hear any criticism.
Pot/kettle...
TJ to the corner of the room. Have a hat with a big D on it.
The likes of McKinsey (already fat from the largess of PFI etc) will be all over these reforms like a rash - that alone is enough to make me highly suspicious of 'em. As with ISTCs, there will be much [i]talk[/i] of competition - as cover for a whole bunch of bloc-contract cherry-picking. I don't see how that is going to improve outcomes at the messier end of acute care.
And if we are going to consider continental-style provision (only feasible with continental-style investment, natch), how about we consider continental-style social service? Making as many people as possible work as care assistants for a year would do wonders for the debate - and it might see an end to [url= http://www.****/news/article-2031199/Nursing-tabards-tell-patients-disturb.html ]this kind of tabloid sh1te[/url] (inwhich the [i]Daily Fail[/i] completely fails to grasp what is involved in undertaking drug rounds). 😈
Project The issue is more why the NHS is sometimes so expensive that a physio appointment with a junior level physio locally was costing about £70 on average with a 6 to 8 month routine wait. The world of NHS budgets is totally Alice-in-Wonderland.
Ermm you are so wrong about the wait time you can self referral, in which you can be scene
within a few days to a week then if you need to revisit afterwards you they will book
you in for your course of Physio.
Errr... What?
No physio self referral on the NHS on our patch.... Shame. If you have it that's great but it is not universal.
We do now have a decent alternative NHS Funded route, via a private provider. Took 4 years of battles though.
But the nhs is not allowed to make a profit or to charge foir the majority of its services, the figures quoted are just figures to fill a column up on a page.
This is in the Bourough of Newham East London
But cannot see this only being offered here, think you may need to check.
Far from it. Trusts have to pay people. They actually do need money. Every outpatient appointment, every day in hospital and every A&E attendance generates a bill. Some do make "profits" which usually get nicked by the failing trust next door. So you really don't want to underspend too much 😉
[i]This is in the Bourough of Newham East London
But cannot see this only being offered here, think you may need to check.
[/i]
Grantway - trust me I know it isn't. It could have saved me making regular formal complaints on behalf of patients.
But its not a profit its surplus to allocated to other hospitals all from the general NHS budget, and just goes to someone elses budget.
As opposed to shareholders, or a private comapny.
I prefer not-for-profit or charitable providers, for the reasons you mention. But the current system allows inefficient and bad departments to continue to function with unjustified subsidies from better ones.
Like Network rail, another revamp of british rail
Stoatsbrother - Member
Errr... What?
No physio self referral on the NHS on our patch.... Shame. If you have it that's great but it is not universal.
All you need to do is go to the Physio department in your Hospital and self referral.
Thats what I did.
I live 6 miles from the Sea. I am sure you must do too. Have you checked? 😉
Stoatsbrother Grantway - trust me I know it isn't. It could have saved me making regular formal complaints on behalf of patients.
Trust me go via a Doctor and you just seem to have no chance having Physio.
My Doctor told me if he made an appointment il wait a year so I self referred
and waited 2 days ?
[url= http://www.circlepartnership.co.uk/ ]As opposed to shareholders, or a private companny[/url]
Funny how those interests which are keen to see the end of the NHS are often those which have benefited from NHS workforce training (not to mention proximity to NHS critical care facilities...).
Not that they tend to talk about that side of things in the marketing, of course.
Stoatsbrother - Member
I live 6 miles from the Sea. I am sure you must do too. Have you checked?
Sorry fella 1 mile to the Thames for me 😉
grantway - Member
Stoatsbrother Grantway - trust me I know it isn't. It could have saved me making regular formal complaints on behalf of patients.
Trust me go via a Doctor and you just seem to have no chance having Physio.
My Doctor told me if he made an appointment il wait a year so I self referred
and waited 2 days ?
The NHS, would function much better wityhout patients being ill.
lol
OK Grantway. I worked with the local physio department on designing their forms, providing web based info on their services and referral criteria, and the same for the new additional service from a private provider. I know that they refuse self referrals.
Used to live in E14 (before the Yuppies arrived) and then E3 myself.
I know that they refuse self referrals.
But they don't?
Used to live in E14 (before the Yuppies arrived) and then E3 myself.
Thanks for that. But born in Plaistow and lived in E3 Mile end and Bromley by bow for about 27 years
and now in East Ham E6 for several years.
😆
Nice for you. Down on the sarf coast we seem a bit behind the times...
As its a private physio,they would need to pay buisness rates and insurance,heating etc, all things the NHS DOESNT HAVE TO PAY.
Errrm you are so wrong this all comes out of the Estates & Facilities budget.
But the hospital is there if there are patients or not, the heating is on etc etc, its all there ,before the first patient arrives, so its just pretend figures on pages
Errrm, no - buildings aren't just fixed cost bonary things that you either have or don't. You can use space in lots of different ways depending on what's efficient.
French or latin. Which is more pretentious?
Zingggggg!
So stoatsbrother where is you private facility getting its physios from? NHS trained physios? there is a huge subsidy as it does not have to train its staff. Seniority? terms and conditions of employment? Research?
Stoatsbrother - MemberNice for you. Down on the sarf coast we seem a bit behind the times...
Clearly.
Stoatsbrother - Member
Nice for you. Down on the sarf coast we seem a bit behind the times...
Obviously This PCT got it right and without Private intervention and non Private funding.
So shouldn't you be contacting NHS Newham to find out how they done this instead of waisting
money on the Private sector ?
where is you private facility getting its physios from? NHS trained physios? there is a huge subsidy as it does not have to train its staff.
So what? GPs and dentists are private businesspeople trained at public expense. In fact, inasmuch as most British people's education is subsidised by the government, most British people are educated and trained at public expense.
Besides, trainees are paid less than a fully-qualified professional precisely because part of their remuneration comes in the form of training.
Seniority? terms and conditions of employment?
Such things exist in the private sector too. By the way, you'll notice you've now changed subjects from whether the private sector is more efficient to whether private sector employees are as well-paid as public sector ones.
[b]G[/b] I'm guessing they did it by having a cooperative management team on the Trust side - based on the way our trust has sandbagged negotiations - and continues to do so in other services. And this is because we are next to the sea it means we have less competition around, no other acute trusts for 20 miles, so they can get away with it. Which is why we have to bring in other providers to get an alternative. If there was Wiggle and no other bike shop would the prices be as cheap and the service as fast?
[b]TJ[/b] That's about your first decent point, but made better previously by someone else. I see you are still not acknowledging the way Labour had [i]totally[/i] got into bed with the private health sector. This is where your political stance seems to blind you. 😉
The bike industry comparison is a good one. Imagine there was no Merlin/CRC/Wiggle/eBay/Canyon/On-One/STW Classifieds. Just a bike shop in every town owned by the government and staffed by TJ.
Well if you wanted a helmet you'd be sh*fted 😆
mcboo - Member
The bike industry comparison is a good one. Imagine there was no Merlin/CRC/Wiggle/eBay/Canyon/On-One/STW Classifieds. Just a bike shop in every town owned by the government and staffed by TJ.
That's exactly the sort of socialist utopia TJ et al dream about. No point letting the hoi polloi have a choice or an opinionm, when those who are better than them could, and should control all of their lives...
Four legs good.....
Just a bike shop in every town owned by the government and staffed by TJ.
😯
Where the hell would anyone buy a helmet?! Or anything with a really nice logo?
Remember all those bike shops you used to walk into where you could FEEL the bottomless pit of bad attitude from the staff? My LBS used to be like that until exactly the week a nice shiny Evans opened up round the corner. All smiles and offers of deals now.
Really? The Evans near me is the surly one. Hate the place.
I try not to go to Evans either. The point is I can use the LBS and not feel like a chump because I now have a choice and they know it.....
Fair enough. I bought my Trek from Evans. They were the only ones to have it in. Leisurelakes were less than useless.
I hated every second of Evans, from being insulted at the door (mistaken identity) to shop assistants being worse than those in Dixons to wanting to just sell me the damned thing so they could sell more trailers and stuff to other shoppers.
Never again. It was like having a poo sandwich, with no marge.
That's exactly the sort of socialist utopia TJ et al dream about. No point letting the hoi polloi have a choice or an opinionm, when those who are better than them could, and should control all of their lives...
Choice is an illusion.
I'd rather have one bike shop that stocked what I want, rather than 1000 shiny suited shysters telling me what I need. 😀
"Choice is an illusion.
I'd rather have one bike shop that stocked what I want, rather than 1000 shiny suited shysters telling me what I need
"
Me too. Whats it's address? I will meet you there.
Trouble is - unless the LBSs are competing with other LBSs or providers - you will get some who are brilliant and well-stocked and helpful out of the goodness of their hearts and because they want to be excellent - but lots will be serving that poo sandwich, because they can get away with it.