NHS Privitisation is coming

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 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. 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.

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.
While I whole heartedly agree with the private sector, and am happy to die by the sword I live by, I also believe that there are some industries that can not or should not be placed in the private sector even if they are inefficient.

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.

I agree with that to an extent and would agree that the level of mismanagement (and the number of highly paid incompetent administrators) is a disgrace. I don’t know the particular circumstances of your area but I know that one of the reasons the private PTS services operating in my area are able to compete and beat the ‘NHS service’ is due to poorer pay, conditions and training for the staff. At this level it is unlikely to have much of an impact in patient care and I would go so far to say that patients are actually benefitting due to greater flexibility in working practices.

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.

Yes TUPE is a powerful act for sure that ties their hands for a few years.
the issue is would we notice in 10 years or 20 years. We seem to have noticed with rail for example, buses [ universality for example]
Competition is not some great cure all that some capitalists maintain. See rural bus routes for example.

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.

mcboo:

My mum nearly had to wait for an operation, but didn’t – > the NHS is screwed and only private companies can save it. Epic fail.

Doris could however choose to go 10 miles further to a charity-run orthopaedic treatment centre, where she will be operated on by a Consultant, where there is no MRSA, where they use the most modern techniques and where they have a great service ethic. The existence of this provider, contracting with the NHS, does apply pressure to the surrounding 3 NHS hospitals to up their game…

In contrast, in some medical specialities, where there is no local realistic alternative, there is complacency, repeated appointment cancellations etc etc

The point I was making is that in a time where we’re being told that cuts need to be made, all the privatisation of the NHS will achieve is to allow people such as him to skim off profit from what are limited and diminishing funds.

You’re very trusting of big business aren’t you? Renowned as it is for its grand philanthropic gestures in the interests of the general population

Now, could you give me any examples of such people (who in Call-Me-Dave’s Big Society actually exist) who in any way give a flying **** about the actual ‘customers’ they deal with? Or, like every ‘utility’ privatised before it, would it be just seen as a gravy train for corporate greed and profiteering?

My mum nearly had to wait for an operation, but didn’t – > the NHS is screwed and only private companies can save it

I think thats a little unfair fella. Go have a re-read, the point I was making was that under the current one size fits all system (she lives in totally unreformed Scotland) if she didnt, like her, have a pushy middle class family behind her she’d have just had to do what she was told and sit and wait. The middle classes work their way around the system, making calls and threatening to call their MP. It’s the disenfranchised, non-connected poor who get royally shafted because beuracracy doesnt listen to you. You think I’m wrong?

Now, could you give me any examples of such people (who in Call-Me-Dave’s Big Society actually exist) who in any way give a flying **** about the actual ‘customers’ they deal with?

Me

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.

Not just the NHS, education and other areas of the civil service are equally as bad.
There is a very different set of values and expectations that public workers have from the private sector, which may or may not be a good or bad thing.
Again I think it’s a question of being over simplified into a Labour/Tory debate rather than a red herring. Generally opinions are polarised into black or white scenarios and I think that the NHS is a bit more complicated than that, and clearly and by stating the obvious here, if STW can’t resolve it in 7 pages no one will be able to.
Efficiencies or inefficiencies in management are oft spoken about and a major cause for concern, but it has reminded me of another area where the public sector could learn from the private sector, but I’m not too sure.
http://www.nytimes.com/1985/07/02/science/moscow-eye-doctor-hails-assembly-line-surgery-at-clinic.html
Then again it might be possible to lea

Seven pages. I’m glad to see that some people haven’t lost their belief that privatisation works. 🙄

El-bent – Member
Seven pages. I’m glad to see that some people haven’t lost their belief that privatisation works everything in the NHS is perfect and that to suggest any sort of change at all is some kind of herecy

😉

Haven’t read all of the above – 😳 – so this question might already have been answered. Anyhoo:

Has any previous privatisation ever lowered costs/improved service levels compared to the old publicly owned days?

Seems to me the move away from public ownership of key services and utilities to private ownership and consequent need to reward shareholders is a major step backwards…

I’m not a communist, by the way. And, to clarify, I don’t work for the a public utility or department.

Has any previous privatisation ever lowered costs/improved service levels compared to the old publicly owned days?

This is an unanswerable question. For any privatisation that some claim has succeeded, others will claim that it would have got better anyway.

It’s worth taking a moment to consider all the stuff that was privatised under the Tories and how a big chunk of it was stuff of which that it now seems inconceivable the state was involved in production. Thomas Cook, ffs!

Amersham International (pharmaceuticals, 1982), Associated British Ports (1982), British Telecom (1984), British Steel (1988), British Gas (1986), British Airways (1987), British Energy (1996), Britoil (1982), British Airports Authority (1987), British Petroleum, British Rail (1995), Cable and Wireless (1981), Defence Evaluation and Research Agency (partial, 2001), Enterprise Oil (1984), British Leyland – privatised piecemeal as Rover Group (1988), Coventry Climax (1982), Jaguar plc, Leyland Trucks and Freight Rover (1987), Leyland Bus, Istel, Unipart, Alvis plc, Royal Aircraft Establishment – partial privatisation, Water privatisation in England and Wales (1989), Electricity generation and distribution in England and Wales (1990), Scottish Electricity, British Coal Industry (1996), National Air Traffic Services, 2 million council houses, Her Majesty’s Stationery Office (HMSO), British Technology Group (now BTG plc), Thomas Cook (1972), National Bus Company, Scottish Bus Group, various bus companies, Rolls-Royce plc (1987), British Shipbuilders, British Aerospace, Property Services Agency, Royal Ordnance (1987), The Independent Broadcasting Authority’s engineering (transmitter) department…
http://en.wikipedia.org/wiki/List_of_privatizations#United_Kingdom

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!

Or it’s actually a sign of a very competitive market. Cartels are hard to maintain because of the high defection risk.