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We know the devastating financial costs to the NHS of profit-motivated provisions from the disastrous consequences of PFI
Really? A quick glance at the property costs of just running my GP sees it running at a little under 8%, compared to the costs of PFI for hospitals that range from about 10-12%. You can argue whether that should go to private companies or not, but throwing words like devastating or disastrous around when the costs of maintaining a hospital are always going to be a part of it's budget is just wide of the mark.
I see journalists saying things like "This money could go to patients" when they talk about Managers or Buildings and the like, and it's a rallying call for every politician, but the fact is the NHS needs buildings and it needs managers and it needs to pay for them.
Virgin were/are being paid £70 every time a bottle of handwash needed replacing around the hospital where one of our mob works. VFM?
You know, I hear that sort of stuff constantly, I’ve never seen it. I worked in a PFI building and it had lights in an atrium that needed a cherry picker hire every time they need replacing, cost to me £8.00
that was Virgin Healthcare as well
Edit: I don't PFI was the best thing ever either, but it's not (by a long way) the biggest threat to the NHS right now.
Really?
Yes really. It is widely accepted that PFI is a not to be repeated failure with devastating financial costs to the NHS. You are of course free to disagree.
but the fact is the NHS needs buildings
Yes the NHS needs buildings. The issue is whether it should be paying more on debt to profit-motivated private companies that have provided them than on drugs for patient care.
Well, it is really. More or less every GP is a privately owned partnership, as is every optician and dentist. lots of the NHS is and always has been privately owned. If they aren’t part of any “reforms” then it won’t work.
Spoken like a true tory.
Didn't we do why PFI was such a terrible failure, some pages back?
I don’t PFI was the best thing ever either, but it’s not (by a long way) the biggest threat to the NHS right now.
So, what is then?
Spoken like a true tory.
That is the reality of the situation on the ground, most people's interface with the NHS (GP, Dentists, Opticians) are mostly (and always have been) privately owned for profit organisations. Sorry.
So, what is then?
Vacancies
with devastating financial costs to the NHS.
There are 127 PFI contracts in the NHS, they are 2% of the annual operating costs of the NHS.
Edit some individual PFI contracts were very badly drawn, and the few in Scotland had limits placed on profits (a much better scheme) but PFI is not and never will be an existential threat to the running of the NHS.
but the fact is the NHS needs buildings
Some years ago, I had to go to the Royal London to pick my mum up after she'd been having treatment. I got off the lift on the wrong floor, and was amazed to see an entire floor of potential wards space, empty. Meanwhile, downstairs in A+E, people were lying on trolleys in corridors, as there were no beds available. I asked a doctor about these empty spaces (several floors worth in fact), and he told me those floors had been allocated for private health care suppliers, but none had taken them up due to them not being profitable.
Let that sink in as you advocate for more privatisation of our NHS.
You know, I hear that sort of stuff constantly, I’ve never seen it.
PFI is a huge threat to the NHS with bills coming due that will cripple it. One example is the edinburgh royal infirmary. NHS scotland has paid huge sums for this ( far more than the cost of the building) and at the end of the contract we still will not own it
I too have worked in PFI buildings and none were fit for purpose being built really cheaply to minimum standards. One example - you could not get a bed out of the bedroom without partially dismantling it and turning on it side and the contract holders despite being responsible for beds did not have the staff to move one when needed. Admin costs were also thru the roof and when food was supplied by the PFI people it was minuscule portions and often barely edible. I had numerous rows with the cook over the food.
Honestly, Doctors are the last people that know what goes on in hospitals.
Let that sink in as you advocate for more privatisation of our NHS.
Germany's healthcare system is 90%-95% (or so) wholly privately owned, they have some of the best outcomes in the world. How one finances a healthcare system isn't a choice between the NHS and the USA.
There are 127 PFI contracts in the NHS, they are 2% of the annual operating costs of the NHS.
Yes you obviously don't agree with the widely held consensus that PFI is a disastrous not-to-be-repeated mistake. Something which I believe even the Tories accept.
Mind you this place would be boring if everyone agreed. So thanks for the alternative pov.
https://www.thetimes.co.uk/article/how-not-to-spend-pound250bn-of-taxpayers-cash-2b0qbphwl6x
nickc
How one finances a healthcare system isn’t a choice between the NHS and the USA.
The problem is that those that would love to privatise health care in the UK absolutely want to push for the American model alone.
I don't doubt that there are countless shoddily run contracts, they existed before PFI and if you waved a magic wand and got rid of PFI then I would bet money there'd still be shabby services, and I'd bet money the buildings would fall in disrepair as managers found that they were suddenly free not to spend it on upkeep, and wards would still be empty and the food would still be shit.
The problem is that those that would love to privatise health care in the UK absolutely want to push for the American model alone.
Yes they absolutely would, I agree, but it doesn't have to be that choice. Even American healthcare companies that I've dealt with told Health ministers in meetings I was part of, that it would be a bad idea.
Yes you obviously don’t agree with the widely held consensus that PFI is a disastrous not-to-be-repeated mistake
yes you obviously want to put words in my mouth. I don’t think PFI was a good idea, I would not want to see their return. They are however not ruinous at 2% or so of the annual cost to taxpayers of providing healthcare
I am sure that its far more than 2% without specially selected timescales or figures but even if we accept its 2% thats enough to give every NHS nurse a decent payrise - and nurses low and falling pay is an existential threat to the NHS
yes you obviously want to put words in my mouth.
Copying and pasting isn't putting words in anyone's mouth.
My comment was directly below this quote of yours which I copied and pasted:
There are 127 PFI contracts in the NHS, they are 2% of the annual operating costs of the NHS.
It is clear to any reasonable person that you are attempting to trivialize the effects of PFI.
You have already dismissed my claim of "devastating" financial costs to the NHS and the "disastrous" consequences.
So your now claimed opposition to PFI isn't particularly convincing.
But if the point you are attempting to make is that you are mildly opposed to PFI I am happy to accept the correction..... you are opposed to PFI but probably not as much as a committed Tory newspaper such as the Times. Is that fair?
Your now claimed opposition to PFI isn’t particularly convincing.
He's said it before.
It is clear to any reasonable person that you are attempting to trivialize the effects of PFI.
I'm not trivialising, those are the costs to the NHS; the figures come from the Nuffield Trust. The early PFI deals were badly drawn, as the NHS (and MOD and Schools) got more experienced the later ones weren't nearly as bad. There's arguments to be made about VFM for some PFI over the traditional ways of raising finance for infrastructure programmes, and the idea that they were a way to "off-book" these costs from the public purse was sly politicking at it's worst. But the fact remains; we have to pay for Hospitals, How would you like to do it?
The argument should be that the NHS should be funded properly; that takes into account the funding necessary for the upkeep of the buildings.
How would you like to do it?
How about by taxing big businesses effectively? IE, actually applying the same existing laws to them that apply to the rest of us? That would be a start....
How about by taxing big businesses effectively?
The tories are quietly defunding the HMRC, an overworked organisation that an increase in funding would be repaid many many times over in investigating and stopping tax evasion. That is a clear vote winner, unless you have to filter your policies through the oligarchs first, then better to just whisper and hope no one hears.
It has of course been going on for years, defund the channels of investigation and prosecution of the rich, while also making legal representation for the poor harder and more expensive. It is a very sneaky way of having one law for all that is in reality applied very differently across socio economic groups.
It is widely accepted that PFI is a not to be repeated failure with devastating financial costs to the NHS. You are of course free to disagree.
Yes, I imagine it's hard to get an impartial comparative view of PFI when you are (checks nickc's posting history) employed in the NHS.
Nickc is employed by those independent contractors GPs. He is not (directly) employed by the NHS.
How about by taxing big businesses effectively?
I'll do @rone's job for him. Taxes do not pay for infrastructure. - they don't pay for anything. Spend first, tax after. My argument would be; there's long term finance for the NHS that needs planning this needs to include infrastructure costs IIRC PFI costs reached a peak in 2017 and the majority of them are beginning to tail away, some of the larger ones will be with us for sometime, let's plan for that.
The Health and Social care Committee recently suggested a simple 4 point plan for ministers to adopt to ensure that primary care services are secured into the future, and they're equally scalable to the whole NHS IMO
1. Fund the NHS adequately to meet it's future needs
2. Reduce the numbers of pointless quality indicators to relieve the burden on clinicians and staff, let doctors and clinicians decide the needs of their patients
3. Offer pay and conditions that ensure staff retention and increase recruitment and start to help to reduce the waiting list crisis that's been allowed to build up - the sooner patients are treated, the cheaper it is.
4. Treat the NHS like professionals, stop micromanaging them, and leave them the **** alone to get on with the job.
TJ is correct, I work for a for profit independent GP contractor.
The tories are quietly defunding the HMRC, an overworked organisation that an increase in funding would be repaid many many times over in investigating and stopping tax evasion.
As an aside, over in the USA Republicans are talking about their day one policy, if they regain the Whitehouse, would be to fire thousands of IRS staff to make it harder for the Federal government to chase evasion. Quicker and simpler to stop the collection of tax to let the well off withhold tax due than it is to change the laws to benefit them on a legal way. Politicians actively encouraging people to avoid tax. A party offering little more than to turn a blind eye to tax evasion and defeat the “Woke”. A party for gangsters and haters. Draw your own comparisons to the UK.
Anyway: NHS … more money & more staff.
Taxes do not pay for infrastructure. – they don’t pay for anything.
🤣🤣🤣🤣🤣
The Health and Social care Committee recently suggested a simple 4 point plan for ministers to adopt to ensure that primary care services are secured into the future, and they’re equally scalable to the whole NHS IMO
1. Fund the NHS adequately to meet it’s future needs
2. Reduce the numbers of pointless quality indicators to relieve the burden on clinicians and staff, let doctors and clinicians decide the needs of their patients
3. Offer pay and conditions that ensure staff retention and increase recruitment and start to help to reduce the waiting list crisis that’s been allowed to build up – the sooner patients are treated, the cheaper it is.
4. Treat the NHS like professionals, stop micromanaging them, and leave them the **** alone to get on with the job.
God - could you imagine something genuinely positive being done, for once? Not sure what I'd do! 🙂
🤣🤣🤣🤣🤣
He's right. The govt doesn't need to tax anyone to fund something. They spend the money first then tax it back later. That's just how the money system works. That's not to say we shouldn't tax big business. But it would be more accurate to say that big business should pay their fair share in tax so to provide price stability across the economy.
He’s right
Another one! 🤣
That’s just how the money system works
Lol! Except it doesn't, because those big businesses (which benefit form having a healthy, well-educated workforce) exploit the inadequacies of the system to avoid paying tax, in order to give the money instead to shareholders etc. Thus enriching the rich even further. Read the post above about HMRC defunding.
Spend first tax after
Except this isn't happening as it should. Hence my comment of taxing effectively.
Germany’s healthcare system is 90%-95% (or so) wholly privately owned, they have some of the best outcomes in the world.
they also pay NI in effect and private health insurance if earning above a certain level. our health outcomes haven't been far behind until recent years. probably about 2012. a coincidence i imagine.
How one finances a healthcare system isn’t a choice between the NHS and the USA.
in the USA the taxpayer funds ~ 40-45% of healthcare costs despite their 'private' healthcare system. also:
Germany’s healthcare system is 90%-95% (or so) wholly privately owned, they have some of the best outcomes in the world.
A lot of which is not for profit. They have a very mixed system with a lot of charity and not for profit providers. This does lead to increased admin costs ( compared to Scotland, similar to england where the fake market nonsense still goes on)
they also spend significantly more on healthcare both in cash terms and in % of GDP terms
And they like to take pills up the bum 🙂
for all the good it's done them they may as well have shoved it up their arse!
probably about 2012. a coincidence i imagine.
From 2011:
https://www.bmj.com/content/343/bmj.d5143
The United Kingdom has the second most efficient health system of 19 economically developed countries, while the US health system ranks 17th, a comparative study has found.
And they like to take pills up the bum
I believe the technical term is suppository. And quite right too - active ingredients are rapidly absorbed into the bloodstream and without upsetting or aggravating the stomach.
The French also like it up the arse, as do most other sensible nations. Brits however get all anal-retentive about such issues. I blame Nanny for being over strict during potty training.
🤣😬
Except it doesn’t, because those big businesses (which benefit form having a healthy, well-educated workforce) exploit the inadequacies of the system to avoid paying tax
I don't disagree. But it's wrong to say big business should pay more tax so that we can fund the NHS. The govt can fund the NHS with as much money as it wants tomorrow. But it will then have to tax that money back later to maintain price stability (ie prevent inflation). A lot more of the money that is taxed should come from big business rather than working people. It's a subtle but extremely important difference. If the voters - and many politicians no doubt - actually understood this then political parties wouldn't have a leg to stand on when trying to implement austerity.
But it’s wrong to say big business should pay more tax so that we can fund the NHS. The govt can fund the NHS with as much money as it wants tomorrow. But it will then have to tax that money back later
****ing hell. 🤣
A lot more of the money that is taxed should come from big business rather than working people
Unbelievable. Arguing, yet agreeing, in the same post.
The French also like it up the arse, as do most other sensible nations. Brits however get all anal-retentive about such issues. I blame Nanny for being over strict during potty training.
They don't like it up 'em, Mr Mainwairing...
**** hell. 🤣
You seem to be struggling with how govt finances work. Which bit don't you understand?
You seem to be struggling with how govt finances work
Oh I do, do I? 🤣 Bless.
Oh I do, do I?
Well yeah because you said the govt has to collect more tax to fund the NHS. That's simply not true.
I wonder if there is a correlation between nations that like it up the arse and well functioning healthcare systems?
A lot of which is not for profit.
Oh I know, the point was that often the "way we fund our health service" argument in this country normally falls to either the NHS model or the wild west of the US system, when in fact there are plenty of other models on our door step that are a good mix of Private and Public spending that could be (somewhat) easily implemented here.
they also spend significantly more on healthcare both in cash terms and in % of GDP terms
Well, yes and no. We spend as much, if not more (UK- 12% Germany about 11.7%) as a GDP measure, but there is more co-pay in Germany (people paying for part of their treatment)
I wonder if there is a correlation between nations that like it up the arse
I'll let you google that one!
UK is not 12% of GDP on the NHS Its been below the european norm for decades. Under blair it reached almost 10% its now back under 9%
Don't add UK private spending in there because its not comparable to the state backed system anywhere.
Well yeah because you said the govt has to collect more tax to fund the NHS.
It's fine if you don't understand what I actually wrote. But please don't make shit up. Thanks.