NHS Privitisation is coming

free schools run by comercial providers will be next too

Yay!

TJ

I must take you to task about the role of GPs – yes they have a good perspective on some parts of the NHS – however they simply do not have the expertise or desire to undertake the role the government envisage.

1) Which bit of this did I misunderstand?
2) What is your expertise in Health Service change outside Dementia services in the last 10 years?

This subject is too important to be simplified into privatisation vs NHS. I’ve put together business cases where shifting activity into the private sector (of which I am not a great fan) could save 50% costs, double activity and get rid of waiting lists… and what happened? – the Chief exec of the local acute trust banned any of her team from talking to me without her present… Many Managers within the NHS tend to think of their organisations agenda and profile first, their next job next, the patients after that, and their employees last.

Many Managers within the NHS tend to think of their organisations agenda and profile first, their next job next, the patients after that, and their employees last.

That sounds more than a little familiar.

To be frank i think a lot of managers, irrespective of organisation, are more interested in their position and their promotion opportunities than they are in what they are actually tasked to do.

Again, and I apologise for dragging it up, but I’m not getting any younger, and have had yet another puncture that finally jeffed me off so much that I rode to the bike shop on a FLAT TYRE AND BOUGHT ANOTHER TYRE…

Sorry, I think the debate should be what/who has the best healthcare system and how do we get there from here? Not who has the largest willy…

Stoatsbrother – I have done plenty and seen plenty. Managed in PFI, private voluntary and NHS healthcare. Million pound budgets

We really are not that far apart in thinking on this either. However pretty much everything I personally have seen where a for profit organisation is involved in healthcare its pants.

Do you really think GPs as a profession are the right group to take on the role envisaged? I don’t. and the statements from various medical bodies has not been enthusiastic to say the least

Stoatsbrother – Member
TJ

I’ve put together business cases where shifting activity into the private sector (of which I am not a great fan) could save 50% costs, double activity and get rid of waiting lists… and what happened? – the Chief exec of the local acute trust banned any of her team from talking to me without her present… Many Managers within the NHS tend to think of their organisations agenda and profile first, their next job next, the patients after that, and their employees last.

Posted 15 minutes ago # Report-Post

But what would the patient experience be,what would be the extra cost for hospital based infections, due to cost cutting,also have you actually worked with real patients or just figures on a computer.

TJ Projects outside Dementia and MH services?

I cannot see who else can give a perspective which is has both a clinical element and a broad scope. Consultants and Nurses as they progress up the hierarchy get to know more and more about a narrower and narrower range of issues.

The Consultants feel threatened and excluded by processes going on at the moment, but try and get them to work and talk together, or do a Friday afternoon operating list…

And once again you are viewing GPs as a whole group. The GPs who will be involved with this and who have driven a lot of the change over the last 20 years are a small group of 5% tops, who can and want to do this. I could do it, but no longer want to. Time for someone else.

Project – well – shifting physio activity outside to private providers for instance – patient experience and outcomes would improve. And some investigations can be shifted very easily, and protocol guided. All this has been done all over the place with good outcomes and high customer satisfaction.

My local NHS hospital breaches waiting list targets, the charity-run private provider up the road gets the same NHS tariff and sees people within a week or two, keeps its MRI waiting list down etc etc etc and has no MRSA…

There are some very weird costings in the NHS, and some very perverse incentives.

Anyway – no point in continuing this – I’ll never convince those who assume external involvement is always bad.

Stoats brother Do you want My full resume? Yes a whole load of different places and I am not MH trained 🙂 What expertise do you have of running large institutions with multimillion pound budgets and many hundreds of staff?

5% tops, who can and want to do this

– yes – so the other 95% will contract out the functions to management companies – hence the stealth privatisation 🙄 these companies are alreay awaiting in the wings. Mind you hospital consultants would be worse. I prefer the current system – this idea is simply going to be disastrous. I do not want one professional group doing this – I want broad based leadership drawn form a variety of places and professional management.

The GPs who will be involved with this and who have driven a lot of the change over the last 20 years

Gps have only driven change over an part healthcare and some of that has been more successful than others.

good professionals have a role in running healthcare – their professional background is irrelevant.

Stoatsbrother – Member

Project – well – shifting physio activity outside to private providers for instance – patient experience and outcomes would improve.

evidence? How about terms and conditions for the staff?

I’ll never convince those who assume external involvement is always bad.

Dunno who that is. I work for a healthcare charity now. No one would think Marie Curie had nothing to offer. there might even be places where for profit companies are good but I have never seen ofr heard of it

Resume

What is this, Gossip Girl? It’s a CV you pretentious bore you.

French or latin. Which is more pretentious?

Stoatsbother,so who pays for the transport of patients from the NHS hospital, to the private practice somewhere else, also Physio is non invasive so no clinical or hospital based infections.

As its a private physio,they would need to pay buisness rates and insurance,heating etc, all things the NHS DOESNT HAVE TO PAY.

So how are the private ones going to be cheaper.

How about terms and conditions for the staff?

I thought healthcare was about patient outcomes

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.
And the strange thing is they have to pay VAT but cannot claim it back unlike private companies.

TJ see this is why I know you don’t know what you are talking about… GPs form/are formed into consortia, and the 95% have the commissioning done, with external governance and oversight arrangements, on their behalf by a board which includes the 5% who do have the skills. And similar organisational arrangements to a greater or lesser extent have obtained for the last 10-12 years, from PCGs to PCTs and PBC. So it is not 95% going direct to private management companies.

I think I’ll have to join that list of people who leave a thread when you join it. There really is no point when you seem unaware of the boundaries of your ignorance.

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.

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.

Posted 2 minutes ago # Report-Post

But thats down to poor management, and poor fiancial planning.

grantway – Member
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.
And the strange thing is they have to pay VAT but cannot claim it back unlike private companies.

Posted 13 minutes ago # Report-Post

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, as opposed to writing out cheques to private comapnies.

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…

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.

TJ 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 talk 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 this kind of tabloid sh1te (inwhich the Daily Fail 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 😉

This is in the Bourough of Newham East London
But cannot see this only being offered here, think you may need to check.

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 ?