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competition for the market, not competition in the market - basic understanding of economics might help you understand that
And a basic grip on reality might help you understand why it's not possible to have individual bin collections. No one would want to provide the service.
Evidence Zulu of the very many unneeded?
[i]why did you try and partially quote me[/i]
Nope, no need to partially quote. Your starting premise is that we are all a "drain". And, yes, I grasp that services must be paid for, by somebody (i.e. the private sector).
[i]that doesn't however mean that the NHS is running at peak efficiency![/i]
No, but the cause of efficiency is not served by the kind of market chat that is so easily bandied about (not least by those interests looking to profit from the privatisation of services). You may think acute care can be run like a supermarket - where choice is facilitated by the switching behaviour of consumers. I would beg to differ. Having an acute MI is not like the planned purchase of fruit and veg.
Because the banks and other financial institutions (all private sector, unless Muppet11 would care to correct me on that) managed their affairs so badly they begged tens of billions of pounds
FFS get with the conspiracy remember that was Gordon Browns fault as he let the B of E set interest rates or he took the house prices out of inflation iirc. Clearly not a failing of private international capital , private companies, or capitalism just shows left wing politics dont work OBVIOUSLY.
Where did I say that noteeth?
at the same time, procurement of drugs and equipment [b]can[/b] be run like a supermarket - Tesco's goes straight to manufacturers and gets the best prices, then runs a large, highly efficient logistics and distribution system, partly in house, partly contracted out... so, how exactly is the supply side of the NHS not like running a supermarket?
Zulu - there is no choice in suppliers for many things for a start.
Evidence Zulu of the very many unneeded?
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there is no choice in suppliers for many things for a start
well, Tesco can sell Tomato Ketchup, made by Heinz, for about 2/3 the price, per 100g, that my local corner shop do - how many suppliers are there for Heinz tomato ketchup?
Is it because anyone can make a bisuits or toilet roll but someone has a patent on the drug? You cannot threaten to go to another cheaper supplier it is like a private sector monopoly and there is no choice and we know how bad that is don't we? Aint free trade /capitalism great.
So otherwise the police would have to do that role or let the traffic jams build up?
Must do better.
Evidence of the very many unneeded public sector employees please E.V.I.D.E.N.C.E
Every single solitary public employee is a drain on the resource
I thought you were a big army fanboy?
Every single solitary public employee is a drain on the resource, every single one is taking money out of the economy
I'm still trying to work out how I'm [i]removing[/i] money from the economy. I don't withdraw my salary from the bank and stuff it under the floorboards.
Some of the money that you pay in tax finds its way to me and from me back out to someone else. None of it is actually removed from the economy though.
[i]partly in house, partly contracted out...[/i]
Actually, NHS Logistics ran a tight ship - and did an excellent job of managing complex supply lines. How strange, then, that NuLab parcelled them (and their assets) off to DHL. It's already been contracted out, as with home oxygen supplies - often with pisspoor results.
I know - let's sell off the RLC to Serco.
[i]Where did I say that?[/i]
C'mon - I [i]know[/i] what you are thinking... 😉
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Is it because anyone can make a bisuits or toilet roll but someone has a patent on the drug? You cannot threaten to go to another cheaper supplier
grey import - its what Tesco's do
and yes, its perfectly legal - and guess what, patents run out and the NHS can provide drugs BP rather than brand name, more money saved!
Grey imports - done when possible already but patents are worldwide and pricing is the same worldwide.
BP equivalents - done already when possible.
'm still trying to work out how I'm removing money from the economy. I don't withdraw my salary from the bank and stuff it under the floorboards.Some of the money that you pay in tax finds its way to me and from me back out to someone else. None of it is actually removed from the economy though.
who pays for the heat and light in your office? me!
None of it is actually removed from the economy though
It is, if you buy something manufactured overseas. Like a bike, for instance 🙂 In reality thought the amount of money leaving the UK if you buy a £120 washing machine is fairly small.
Anyway I was under the impression that the NHS being a very big customer was able to get some really low prices out of suppliers?
Counter intuitively, I think the problem in the public sector is actually the fear of waste. My experience from when my wife worked in management in a government department was that there seemed to be dislocation between the budget she administered and the cost of administering the budget. Her team grew and grew until the incremental budget increases were pretty much matched by the increased staffing costs but because this came out of another budget no connection seemed to be made. What it demonstrated to me was that there was an almost paranoid fear that money might be wasted but the cost of this paranoia was almost as great as the maximum possible waste so actually nothing had been achieved. In my view, it would have been better to strip away layers of controls and just accept that people will make mistakes from time to time leading to some waste. This will, in my view, lead a lower overall cost than that of trying to drive it out of the system, which in a fallible world is never going to be possible. (There is plenty of waste in the private sector.) The problem with this utopian view is of course it will be difficult to find politicians who are comfortable defending waste.
Good analysis mefty with a relevant point.
Because the banks and other financial institutions (all private sector, unless Muppet11 would care to correct me on that) managed their affairs so badly they begged tens of billions of poundsFFS get with the conspiracy remember that was Gordon Browns fault as he let the B of E set interest rates or he took the house prices out of inflation iirc. Clearly not a failing of private international capital , private companies, or capitalism just shows left wing politics dont work OBVIOUSLY.
I could point out that the central banks that are supposed to stop us from getting into this mess are public institutions, but I won't. 🙂
who pays for the heat and light in your office? me!
Your taxes go to my employer, who pays the electricity company. Unless the electricity company is stuffing the cash under the floorboards, that money hasn't left the economy.
It is, if you buy something manufactured overseas. Like a bike, for instance In reality thought the amount of money leaving the UK if you buy a £120 washing machine is fairly small.
As a wishy-washy Grauniad-reading public sector-worker, am I more likely to try to buy locally sourced goods?
😉
Good post, Mefty.
[i]This will, in my view, lead a lower overall cost than that of trying to drive it out of the system[/i]
Don't tell the likes of McKinsey... how will they afford to [i]live[/i] - if they can't dispense their expensive-and-oh-so-valuable advice to us? 😯
Unless the electricity company is stuffing the cash under the floorboards
Or spending it on coal from overseas.. oh wait.. they are.
Mike, good luck finding a locally sourced washing machine or any other manufactured items...
Or spending it on coal from overseas.. oh wait.. they are.
As a wishy-washy Grauniad-reading public sector-worker, am I more likely to get my electricity from Ecotricity?
Mike, good luck finding a locally sourced washing machine or any other manufactured items...
In which case, it doesn't matter if my employer is spending the money after getting it via taxes, or Zulu-Eleven. From the point of view of the economy, anyway.
😉
who pays for the heat and light in your office? me!
Really your name is not on the bill can I send it to you directly?
Again z-11 if we privatise the NHS and we all pay the same amount of money to it via a % of our wages or insurnace or whatever has it miraculously started to make money JUST because it is the privaye sector even though nothing has changed in terms of income or expenditure? It also gives a fair amount of it's money to the private sector as well for medicine , equipment etc.
Patents last 20 years - but can be extended to make up for the time it was tested- should we let people die whilst we wait for it to lapse?
started to make money JUST because it is the privaye sector even though nothing has changed in termsof income or expenditure?
Except that there'll be a load of shareholders to pay for. And hospitals will start to give us treatments we don't really need so they can bill insurance companies... so insurance goes up and poor people are screwed. That'd be great.
healthcare which is the area I know - private healthcare is more expensive with poorer quality than the NHS
I realise it would cost more ,whilst being more efficient, apparently.
The point is z-11 goes on abnout how we make nothing and live off him but we could do the same thing witht the NHS via insurance to a private firm rather than tax and suddenly we would have a private company making things ....which seems a bit of a silly argument IMHO.
private healthcare is more expensive with poorer quality than the NHS
Is that like for like? Maybe not possible to say but if I go to a private hospital maybe I get a few more luxuries?
[i]And hospitals will start to give us treatments we don't really need[/i]
Indeed - over-investigation will be where it's at. Ching-Ching.
As it is, I'd rather have a medic investigate/treat immediately, if needed... or [just as importantly] keep a wary eye on me for a few days... or [equally important] politely tell me to **** off for wasting NHS time.
that like for like? Maybe not possible to say but if I go to a private hospital maybe I get a few more luxuries?
Are yu suggesting that mor emoney would equal a better service GENIUS.
They also have the incentive to treat you for things that dont exist as they can charge someon for it so a bit off both iirc some capitalist like making money more than they like morals.
And hospitals will start to give us treatments we don't really need so they can bill insurance companies... so insurance goes up and poor people are screwed. That'd be great
Not iof it's a long term illness with poor prognosis, eg dementia. Then the hospitls won't want anything to do with you, what privatre healtcare wants is quick, expensive treatments, kerching, next please.
Not sure why you are trying to cause a fight at every turn but I'm trying to extract more from TJ's statement - he says quality is poorer for more money but I don't get that. I've not had much to do with the NHS or private medical providers so am fairly clueless but I do have private medical cover so I assume I get something extra for my care in a private supplier than the NHS. But maybe I'm wrong and it's all a big con?!
BTW the only reason I have it as my employer gives it to me otherwise I'd be happy with the NHS.
I could point out that the central banks that are supposed to stop us from getting into this mess are public institutions, but I won't
Good, saves me the bother of pointing out that central banks in most countries, including Britain, are not regulatory authorities but bankers to the state, so have little to do with how private sector banks conduct their affairs.
tiger_roach - Member
Is that like for like? Maybe not possible to say but if I go to a private hospital maybe I get a few more luxuries?
yes - like for like. I am talking about the private treatment centres brought in to reduce waiting lists and to create that bogus choice.
Perhaps the carpet was cleaner and the food better but the infection and complication rates were higher as was the cost per operation.
Similar for long term care.
tiger. The NHS has economies of scale and is far more efficient ( oftena t the expense of convenience to the user) The private sector pays out profits to shareholders - the two things together mean that private healthcare is more expensive.
The nicer carpets and food is a very minimal cost
The NHS is pretty much the most efficient provider of healthcare in the world. The downside is this comes at a cost of flexibilty / convenience to the the user. Thats the main thing you get when you pay private.
the NHS runs at high efficiency becauese of this
[i]I assume I get something extra[/i]
Glass of wine.
By and large, the private sector concentrate on elective procedures in the otherwise fit n' well... handy for access to knee specialists, etc. Chronic illness, etc - not unless you have [i]deep[/i] pockets. They don't have a large ITU capacity, but are usually not far from larger NHS facilities. So, if things go wrong/get complicated, they just transfer you out... In other words, they can avoid expensive stuff.
TJ- I don't doubt all you say but I assume/hope my employer pays £1k or so pa for my health insurance so that I get better service than I would in the NHS - maybe that just means faster treatment so I am back working a bit more quickly? Dunno really. I guess my time in the hospital would be more enjoyable even if that's just because I get to stay away from poor people... 😉 My wife will be giving birth in an NHS hospital soon and can't really see that a private hospital would offer much more - a private room I suppose.
Whilst you may have been comfortable with my post, you will not be comfortable with my view that it is this line of thinking that underpins the free schools policy despite the rhetoric.
As far as consultants are concerned, everyone in the private sector knows that they exist to back up unpalatable decisions already made by the senior management.
Unfortuatly tiger you get better "hotel" service and more convenience but worse healthcare.
he says quality is poorer for more money but I don't get that
The biggest cost in most organisations is labour. Clinical labour is pretty much fixed, so if a non-NHS organizattion wants to hire doctors and nurses, they do so at the same cost as the NHS. No saving. They might use non-NHS clerical staff at a cheaper rate, but the savings there are slight and not enough to build in enouigh of a profit, so the provision of healtcare by the private sector is more expensive than by the NHS. And whilst the clerical staff know about handling patient data, making appointments, allowing for patients to be prepped, the private sector workers won't, so you get a poorer service for more money.
Something which happened to us recently when we farmed out a fast track diagnostic and treatment centre to the private sector (20% more expensive, 30% fewer patients).
Another way of lookking at it is this - the NHS exists to do one thing - look after your health. Nothing else. Any other activities will ultimately have your health as their focus.
Private companies exist to dom one thing - make money.
What do you want to be the focus next time you're ill, your health and the treatment of it, or how much it'll cost to treat you?
my employer pays £1k or so pa for my health insurance so that I get better service than I would in the NHS
As TJ says, faster service in a better hotel. Our local private hospital uses NHS consultants doing private work. And guess where that hospital;sends you if you need an MR or CT scan?
so the bones of it - the treatment - is just the same
The healthcare thing is also about efficiency. When you don't give people choice and are prepared to make them wait you can plan the use of facilities and staff to get the maximum output.
When you give people choice and don't want them to wait you end up with slack in the system.
Yes. You should work your shocks off and stop blaming this or that..
😈
Unfortuatly tiger you get better "hotel" service and more convenience but worse healthcare
But is that worse for the individual or just overall for the cost? All I'm getting at is that better service costs more in diminishing return sense and many are willing to pay for that - same as with Hi-Fi and bikes right?!