[Closed] NHS Privitisation is coming

Where the hell would anyone buy a helmet?! Or anything with a really nice logo?

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Me too. Whats it's address? I will meet you there.

So you're happy to nationalise cycling?
Excellent!

I KNEW I'd be hailed as a genius eventually.......

Obviously, the quality of bike you will be able to buy will be directly related to your actual, not percieved cycling ability.

We don't want to be wasting precious resources on those without the need for them (mincers like myself, for example) do we? 😀

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Why are we making our very efficient health service more like the very unefficient American health service? So that the Tories' friends in big business can get a slice - no other reason whatsoever. All this rubbish about choice and competition - yeah it really worked for the railways didn't it? Nationalise the cost, privatise the profits - brilliant.

The history of the NHS and the wider welfare state is a record of failed attempts to curb the costs of the over-optimistic promises made by politicians.

Throughout is history (arguably from 1911 or more normally since the 1942 Beveridge Report) no-one has been able to control the costs of a service where the demand is infinite and the benefits are not linked to contributions.

We have been conditioned by the idea of a free and universal health system but in reality this never existed. Right from the outside, governments were warned about having an open-ended burden of the NHS and not surprisingly the first three years of the NHS were not the success people like Bevan had suggested. From the start there were problems with cost over-runs, lengthening waiting list (the socialist alternative to charging for the service!) and the realisation that this was a system that didn't work/couldn't be funded. So WITHIN three years, charges were re-introduced leading to Bevan's resignation.

Who should pay for health care then became a political hot potato with costs being scrapped/introduced/scraped etc over the next 20-30 years....so the debate is hardly a new one.

Turning to today, there was a study by the LSE's CEP that concluded that, "in an organisation the size of the NHS hundreds of lives appear to be being lost because of poor management." The authors concluded that, "NHS managers seem to be incompetent compared with managers in the private sector."

Tim Harford (of The Undercover Economist fame) concludes that, "A better diagnosis is not that the NHS is missing some elusive quality of private sector-iness, but that it is missing any sort of competitive pressure, the sort of competitive pressure that most businesses (outside banking) have to cope with every day...Competition raises standards – something that should be music to the new government’s ears."

I have some sympathy with the CEP conclusion. The sad fact is whatever system you chose, if you put monkeys in charge, you will end up with a mess.

Competition [i]might[/i] work in certain circumstances to improve efficiency - but in some sectors it's false competition. Take the example of the trains - you don't decide to go to Glasgow instead of Leeds because you prefer the train operator. All you want is to go to your desired location with a decent service at a reasonable cost.

Does anyone really want to be studying hospital league tables and googling stats on the record of a particular A+E department? Or do they just want to receive decent care from the nearest place (which the vast majority of people currently do)?

"Choice is an illusion" or "Choice can be an illusion"

...makes me think of how a few interested parties can manipulate areas of public life. The latest being Simon Cowell's SYCO who have been able to dominate and manipulate the ITV 'entertainment' section. I shed no tears to read that the latest drivel "Red or Black" is struggling. Perhaps the public is seeing through blatant promotion of SYCO's investments eg, Il Divo last night.

the hoi polloi

terribly tautological...
Classics teaching in public schools aint what it once was

Does anyone really want to be studying hospital league tables and googling stats on the record of a particular A+E department?

However you feel about the proposed reforms and the status quo, trotting out rubbish straw men is just a waste of time.

Except that's not what anyone is suggesting......

However you feel about the proposed reforms and the status quo, trotting out rubbish straw men is just a waste of time.

Except that's what you are encouraged to do now, under Labour's own bullshit 'choice' initiatives. Maybe not for A+E departments but last time I had to have an operation I was given the 'choice' of different departments at different hospitals where I might like to have the operation.

The Tories are talking increasing 'choice' - and I just think the concept is bogus.

I think we can all agree the railways are not a fabulous example of competition in action. National infrastructure v local services, please stop trying to make that connection. Straw man/Aunt Sally/bullsh1t.

I think we can all agree the railways are not a fabulous example of competition in action.

But lots of people seem to be suggesting competition automatically = better efficiency, which is clearly not the case.

And if we are into criticising other people's arguments - all your emotive stuff about your family members is hardly adding anything to a sense of measured debate is it. Maybe you have some criticisms of the report I linked to above showing the NHS to be one of the most efficient health services in the world? Or does your personal experience trump proper research?

I think we can all agree the railways are not a fabulous example of competition in action.

OK, give us one example where privatisation of a previously nationalised service has resulted in a cheaper, fairer and more efficient service for the customer.

Telephony.....how'd you like The Post Office to be the ONLY provider of your home/mobile/cable?

All the introduction of 'competition' and 'choice' has done is to deliver previously public services (initially built up with taxpayers money, lest we forget) into the hands of Private Monopolies and cartels who then use their position to screw us all

If I want to et the train from Manchester to London I can use Virgin or ....erm.... nope, that's the limit of my choice, I'm afraid. As a result of this they have raised fares every year by, in their words: "as much as the market will bare"

And the supply of gas and electricity has been great for everyone since its been de-regulated, hasn't it?

As Martin Lewis pointed out, since privatisation there hasn't been a single incidence of one supplier raising prices, where the otehr suppliers didn't immediately do the same. That's not a competitive marketplace. Thats a cartel!

But in both these examples of blatant, completely anti-competitive and anti-choice profiteering, someone, somewhere is making a hell of a lot of money!. I'm sure the same people are rubbing their hands with glee at the opportunities the 'marketisation'* of the health service will provide

* I absolutely despise that word!!!!

Airlines. What would rather fly on, Aeroflot or Virgin?

Airlines. What would rather fly on, Aeroflot or Virgin?

British Airways, pre 1987.

Telephony.....how'd you like The Post Office to be the ONLY provider of your home/mobile/cable?

I'd be bloody delighted.

Too many tariffs designed to confuse, false competition, outrageous charges, non existant customer service etc, etc.
All as a result of privatisation.

Your life sounds sh1t.

Binners - your observations may be valid but your arguments are not. What you are highlighting is the fact that in some cases of privatisation we still do not have sufficient competition. That is very different from saying that competition is bad in its own way.

You will not find many people defending cartels - apart from the owners!

One of the most frustrating things that I find about the NHS is the complete lack of service ethic. When I enter a hospital it is like walking into another world. Coming from a lifetime of private sector working, I always struggle when I see groups of nurses sitting around having cups of tea and a biscuit when there are lines of people waiting to be helped. When I went to an A&E department in an eye hospital, they registered me very quickly (I assume because that is a performance indicator [sic]?) but then left me to wait 6 hours to be seen by a doctor. What other business would survive with this kind of ethic?

Your life sounds sh1t.

Again, really great argument. 🙄

Binners - your observations may be valid but your arguments are not. What you are highlighting is the fact that in some cases of privatisation we still do not have sufficient competition. That is very different from saying that competition is bad in its own way.

OK, so genuine competition [i]might[/i] lead to an improvement in service - what [i]definitely won't[/i] lead to an improvement is false competition and the same inefficiencies, with private companies taking a hefty slice out. Which is exactly what we have in most of the privatised industries, and what we are going to get here.

Healthcare is such an emotive subject that people let their political ideals get in the way of rational debate....choice is being thrown around by various MPs as a concept of allowing patients to choose where to go for treatment....they are doing what politicians always do and pandering to the public....when i pick people up to go hospital they often stipulate what A&E they want to go to, even if the closest one is literally just round the corner, this has been going on for as long as i've been in the job (11 years)....its not a new phenomenon....it is however a pain in the arse as people make choices about their treatment on such frivolities as which hospital in the area has the best food....or simply local gossip.
The public (in general) do not make well informed or well researched decisions, instead focusing on hearsay and choosing whatever their mate from work chose too.

As others have said, the way it will realistically happen (and already has been for about 10 years now!...keep up at the back) is that organisations (including the NHS) will bid to provide services in an area and generally use the staff and infrastructure that is already in place....this is the way it currently happens and the way its happened for as long as i've been with the NHS....it was happening under Labour too but its amusing to see people overlook that fact and paint this as a current Tory idea.

When my NHS trust lost the contract for non emergency ambulance journeys in the area it went to GSL (now G4S) and the new firm tranferred all staff across, bought the vehicles we'd been using and the service continued the next day as though there'd been no discernible change....GSL were able to offer a cheaper contract to the hospitals because they didnt have ambulance stations to maintain and they had about half the number of managers we are lumbered with in the NHS.

Same process happened with police custody duties in the area that Hampshire Ambulance (now south central) were covering. They lost the contract to a firm called Primecare who then lost the contract to G4S....each time the staff moved with whoever was providing the services and there was no discernible change to staff or the end user.

There are a huge amount of scare tactics spouted by people when this subject is broached, in reality if a private firm took over your local A&E tomorrow you would likely not notice any change in the service you received....you would see the same staff in there as had been there a few days earlier under NHS management....you would probably see the new firm's logos everywhere but then the NHS plasters its logo everywhere too and there would undoubtedly be far less managers....this is a good thing, the biggest bill in my NHS trust is the wage bill so it makes sense to cut all the staff who are not essential for front line work, this is something the private sector is very good at and something the NHS struggles with....hence all the non jobs available in the NHS and the hugley inefficient use of frontline staff seconded onto desk job projects.

As somebody who works in the NHS i dont see the problem, due to the corporate manslaughter act and the generally litigious society we live in today, private firms who are already involved with NHS contracts know they cant deliver a sub par service or they will be bent over and royally shafted....and then lose their contract to a rival anyway.
Providing a poor service is not in their interest.

mcboo - Member

Your life sounds sh1t.

It was better when it was state owned 😀

Anyway, surely it's time for your milk and a nap?
No one like a sourpuss and grumpyface on their first day in big school.

what definitely won't lead to an improvement is false competition and the same inefficiencies, with private companies taking a hefty slice out.

OK so you give us an example of healthy competition. Or is all competition false, everything is a cartel, everything is crap etc etc rant rant rant

All as a result of privatisation

Rusty - do you really believe that?

OK so you give us an example of healthy competition.

How about you do, seeing as you're the one arguing for it?

I can see some arguments for genuine competition, but I think those are largely cancelled out by the tendency towards monopolies and cartels (and using undue influence) as soon as a company gets to a large size. I would personally be in favour of much tighter regulation to prevent monopolies/cartels/unfair practices.

Pretty much, yes.

If you prioritise profit over service, legitimise greed and encourage the provision of the cheapest, shoddiest product at the lowest possible price the only person who suffers is the end user.

Some things, morally, should not involve any element of competition and profit & cost (NOT efficiency) should be irrelevant.

Power, water, telecoms, health, education, prison services, social care etc.

I did above, I gave two. And I also agree privatising national infrastructure like the railways has not and could never have benefited from an injection of competition.

Your turn now, you give an example of good competition in practise. Show me you aren't blinded by dogma.

People who have the freedom to choose their healthcare supplier will benefit from a privatised healthcare system.
People who do not have the freedom to choose might just lose out.

Telecoms? Yes that Steve Jobbs is a total bastard. Jonathon Ive? Swine.

OK, so genuine competition might lead to an improvement in service - what definitely won't lead to an improvement is false competition and the same inefficiencies, with private companies taking a hefty slice out.

Agreed, but this doesn't lead to this...

...and what we are going to get here.

The inability to face facts that the NHS has many strengths and many great people working in it who provide excellent care but is poor system for allocation of resources (hence my earlier historical post to show that is was ever thus) is like politicians pretending that they will be able to save the euro system in its current form!!

People who have the freedom to choose their healthcare supplier will benefit from a privatised healthcare system.
People who do not have the freedom to choose might just lose out.

Great. We agree. Lets give everyone the choice.

I'd still like to know if anyone can tell me:

1.In Singapore does everone get instant access to surgery/procedures once a diagnosis is established.

2. What happens once your allocated pot of money has been exhausted as per the figures I quoted from the Singapore Minisrty of Health eg Lung cancer with complications - you have enough money for 7.7 nights in hospital. What happens once you've had your 7.7 nights of treatment?

I'd still like to know if anyone can tell me:

1.In Singapore does everone get instant access to surgery/procedures once a diagnosis is established.

2. What happens once your allocated pot of money has been exhausted as per the figures I quoted from the Singapore Minisrty of Health eg Lung cancer with complications - you have enough money for 7.7 nights in hospital. What happens once you've had your 7.7 nights of treatment?

I don't honestly know.

Fair enough, although it was being touted as a near perfect system but seemed to have areas which concerned me.

Great. We agree. Lets give everyone the choice.

GSL were able to offer a cheaper contract to the hospitals because they didnt have ambulance stations to maintain and they had about half the number of managers we are lumbered with in the NHS.

My employer is in the final stages of gaining 'Trust Status' which will give them greater control over their funding and spending. I feel this may only achieve the worst of both private and NHS camps. There will be those who benefit of course but I would bet it's not patients or front line staff.

I'll let you sell that one to 85 yr old Doris on her state pension who needs to decide whether to have her hip replacement done in that there London or Edinburgh

Doris might need some help, maybe her GP could do that. If she lived in Edinburgh why would she want to go to London for an operation? That would be stupid. As would denying choice to the vast majority of the population who are capable of making an informed decision. We are not idiots, we ought to resent being treated as though we were.

Treasure your NHS!

We don't have it here in Ireland. All but the very poorest pay €60 for a GP visit €100 to go to A&E without a doctors referral (which you've paid €60 for) and then all your medical costs after that. 50% of the Irish population have medical insurance (it's 12% in the UK) - not because it is good but because the public system takes so long to get into and it keeps the costs down to extortionate rather than impossible. It's a very expensive business getting sick here.

I lived in the UK for 6 years and my wife lived there for 13 years and truly know the NHS is wonderful and in my opinion the true symbol of a civilized, caring and modern society.

Don't give it up without a hell of a fight. It is is what makes Britain Great not nuclear weapons and pompous politicians.

To give you an idea of who benefits from the NHS changes brought in thus far, I'll give you an example.

A few years ago I had the pleasure of sharing office space with a recruitment firm. They were specific. They recruited management for the NHS. That was it! Not nurses or frontline staff, actually delivering services. Hell, no. Just middle managers.

The guy at the time was driving a brand new X5 (private plate of course), and swanned around in his expensive suits, acting ****ish, like he was Lord God Almighty. The guy was an absolute stroker. But he was clearly making an absolute killing out of the health service, and cobviously lacked the morality to question why his affluent lifestyle shouldn't be funded by our nationalised healthcare system? To the obvious determent of frontline services.

Somehow I suspect that an awful lot of people just like him are presently licking their lips at the prospect of providing 'services' to the people who write the (large) cheques for our healthcare system

Don Simon - agreed to an extent and feel that the whole public versus private, Labour versus Tory debate is essentially a red herring. There is bad and inefficient management in both sectors. But the NHS does seem to suffer from particularly bad management/service culture.

The alternative view for poor Doris is to tell her that (1) its ok, she will be helped and have her hip replaced but (2) she will have to wait a few years 😉

A few years ago I had the pleasure of sharing office space with a recruitment firm. They were specific. They recruited management for the NHS. That was it! Not nurses or frontline staff, actually delivering services. Hell, no. Just middle managers

Another straw man

Why? Do elaborate....

Yuppie scumbag drives car I dont like and robs NHS - > If you argue in favour of reform you are vermin like him. Epic fail.

There are a huge amount of scare tactics spouted by people when this subject is broached, in reality if a private firm took over your local A&E tomorrow you would likely not notice any change in the service you received....you would see the same staff in there as had been there a few days earlier under NHS management.

All but the very poorest pay €60 for a GP visit €100 to go to A&E without a doctors referral (which you've paid €60 for) and then all your medical costs after that.

Does that mean that they don't waste money on sky sports?

50% of the Irish population have medical insurance (it's 12% in the UK) - not because it is good but because the public system takes so long to get into and it keeps the costs down to extortionate rather than impossible. It's a very expensive business getting sick here.

Interestingly, the very first version of the NHS in the UK was means tested in a similar fashion. But this was resented and led to the introduction of the universal benefit system (Beveridge/Bevan). But this didn't work due to the cost element and lead to the inevitable planned economy way of dealing with demand > supple...waiting lists. This was then replaced by charging people. So getting sick has always been a combination of being expensive or lengthy to sort out. Not just an Irish problem.

The 12% versus 50% is an interesting stat. Its amazing that people are prepared to spend their income on the absurdity that is football/sky sports but not on their health. They will argue that this is their choice but are not happy to live with the consequences.