The paper towels were privately supplied … Overpriced

I suggest that you’re probably not old enough to remember when the government did make paper towels and toilet paper

I am, and I can tell you for sure that if you had used that stuff to wipe your arse, you wouldn’t think that what we’ve got now is overpriced 😆

Or we

Paycap NHS staff at £100,000
Stop employing management consultants
Start sourcing medical consumables direct from manufacturers.
Shut down ( and buy out existing ) PFI deals
Take all IT back in house and stop using Microsoft etc.
Invest in Nurse training
Completely remove the whole commissioning structure and use taxes to pay for actual healthcare.
Bring all community Trusts back under the Acutes so they can be funded to provide the beds for bedblockers

Love how ninfan pretends to be curious about it before pretending to find out it is all a big plot by those evil scummy unions protecting their own interests over the public’s.

If it helps you come to terms with what unions do, (although i realise that you are well aware of the differences and similarities already), you might in this case consider Unite as a poorly-skilled lobbyist that is not a patch on those true professionals lobbying in secret over £500-a-plate dinners for ttip a better deal for the honest hardworking taxpayers.

ninfan

https://my.supplychain.nhs.uk/Catalogue/product/mrt155

Luxury!

Overpriced or shamefully poor procurement?

“Damn you got me there”

Ohhh hang on a sec, We outsourced all our procurement to DHL years ago.

http://www.supplychain.nhs.uk/suppliers/key-facts/

you going to stick with “shameful”, or “spin” that too

Hoisted/Petard

It’s the political elephant in the room that no one will touch due to political suicide.

We talking about the NHS here or benefits?

It gets my support, I’m in A&E every day with stubbed toe or a runny nose.
I do wish theyed be a little more organised, there’s always queues of cyclist in the way. The don’t pay road tax so should not be allowed in A&E.

I do wish theyed be a little more organised, there’s always queues of cyclist in the way. The don’t pay road tax so should not be allowed in A&E.

****!

Or we…

Well said, samunkim – good list.

Whatever its flaws, the NHS has provided healthcare at less-than-continental levels of investment. A Franco-German style social-insurance system doesn’t necessarily do more with less, and they don’t (and will not) escape many of the challenges that the NHS faces. Glib talk of “competition” is meaningless in acute care – you need to pool risk/expertise… indeed, collaboration helps to keep costs down, and that’s true of every developed healthcare system on earth. Like many on here, I’ve seen the NHS at both its best and at its worst – and I’m pretty fugging alarmed by the direction of current reform. The sales-pitch of “services free at the point of use, but it doesn’t matter who provides ’em” is starting to wear pretty thin.

If we are going to play blame-games, it’s no small irony that [pseudo-]market reform has led to a rise in bureaucracy & cost (not to mention a plague of seconded Mckinsey parasites & increasingly-byzantine commissioning process). Arguing whether the ’12 HaSC re-org (itself a costly & often-bonkers enlargement of NuLav policies) represents ‘privatisation’ is a semantic side-show, IMO – given the track-record of Serco, Crapita, etc, the fact that services have been outsourced is not an argument in favour of the process. And as provision become increasingly fragmented, “other providers” are simply leaving the risk to NHS acute care. The recent Circle saga at Hinchingbrooke is an excellent demonstration of this – far from achieving improved “efficiency” (and despite all the glossy PR), Circle simply threw in the towel.

Or we stop the Trident Missile replacement programme and bounce the money to the NHS, we fix tax loopholes or introduce Robin Hood tax.

Why? Fix the problems rather than throwing money at it.

The NHS is like a bath without a plug. Keep the taps going! Turn them up high!

No-one seems to think that putting the plug in is worth doing.

And capping salaries will just mean that you’ll not get new bright folk in.

Far better if they didn’t just get paid more for been there longer.

And also someone should remind the Govt/Senior Mgt that the only people they are bidding against are themselves – when it comes to staff (and temp staff). For example, who else employs a Radiographer (in any great number) than the NHS; or why pay bank staff w/e rates of pay?

Why? Fix the problems rather than throwing money at it.

Or maybe just maybe do both.

But if you fix the problems first, you don’t need as much.

But if you fix the problems first, you don’t need as much.

Yup.

The NHS is like a bath without a plug. Keep the taps going! Turn them up high!

I’m going to suggest that my NHS Trust re-brands itself as a bank. 8)

But if you fix the problems first, you don’t need as much.

In certain respects, yes – “upstream” prevention, etc. But all developed healthcare systems face the same issue, viz the health/social care needs of an increasingly elderly population.

And also someone should remind the Govt/Senior Mgt that the only people they are bidding against are themselves

One of the loopiest aspects of current reform is the added complexity/bureaucracy of the “competitive” bidding process. As was widely predicted, lawyers & management cons. are having a field day.

Poorly managed.

Needs an alternative.

As a family we contribute probably over £10k in taxes to the NHS and get far from adequate service. I would rather have another option than trying to plug a hole in a sinking ship with tissue paper.

Poorly managed.

Needs an alternative.

Fr/Gr systems will still cost – [safety-netted] acute care will still face much the same issues.

Besides which, I wouldn’t trust the incumbent shower with introducing a robust social-insurance system, any further than I could throw fatty Pickles.

can i ask….

if we pay for the NHS with our taxes, do people really think we would see a tax cut if the NHS was privatized? Honest question.

I think its highly unlikely, so the out come would be the same tax, but with additional health insurance costs.

Also, what i don’t understand is why the NHS is now too costly, when it was introduced just after the second world war, when money was even tighter?

Does it mean not enough of our GDP is going back into the country?

Also, what i don’t understand is why the NHS is now too costly,

Old and fat population.

more old and fat than the 1940’s (fat people maybe)

I believe a free health care is essential

more old and fat than the 1940’s (fat people maybe)

baby boomers

10 million people in the UK are over 65 years old. The latest projections are for 5½ million more elderly people in 20 years time and the number will have nearly doubled to around 19 million by 2050.

Not only that but the NHS wasn’t setup to do all it does now. It was supposed to be front line care only and a lot of stuff couldn’t be diagnosed or treated. Now we can keep people in an undead state for years.

I believe a free health care is essential

It’s never free though is it, you’ll pay one way or another. However, at present there is no incentive to look after yourself. Get p*ssed and smash your head open, who cares get someone else to pick up the cost.

http://www.telegraph.co.uk/news/health/9444286/Hundreds-of-small-decisions-will-save-the-NHS-money.html

http://www.bbc.co.uk/news/health-14971984

The NHS buys 652 different types of glove. The lack of standardisation even on day to day low cost supplies is one of the reasons that £billions is wasted every year – it’s a free for all even on low cost items – when you look at the variance on expensive equipment like defibrillators you’ll find “purchasing managers” (that in many instances actually have no relevant experience or qualifications) that are buying the same item as the 3 miles Trust down the road but paying 5 times more. When the delta of prices paid by trusts per item is literally £10,000 or more it tells you something about the lack of planning and control.

Someone mentioned expensive drugs earlier in the thread – the actual facts show us that the UK spends amongst the lowest on medicines as a percentage of GDP and pays some of the lowest prices on branded and generic drugs in Europe – prices on patented drugs are currently also subject to a multi year price freeze.

Also, what i don’t understand is why the NHS is now too costly,

Someone mentioned prevention briefly, which is relevant.

Lack of joined-upness in “the system” plays a huge part – remember Dave, Gideon and fat Eric with their plan to “protect the NHS” in part by passing on enormous, and I do truly mean enormous, cuts to funding for local authorities? And remember how part of the top-down reorganisation of the NHS (which Dave promised not to do) included tranferring commissioning responsibility for public health from the NHS to local authorities?

Cuts to funding mean either services being cut entirely, or eligibility criteria raised (so you might have been eligible for a particular mental health service with “substantial” needs five years ago, but now you only get in if your needs are “critical”).

Fewer people being supported to either sustain or improve their wellbeing with relatively low cost interventions has the obvious and direct result of more people going into hospitals and requiring much, much more expensive treatment.

This, in a nutshell is what people are getting at when proposing that health and social care should be integrated, by the way.

See also: bed blocking (person is well enough medically to be discharged if they have a suitable housing situation to be discharged towards, but they don’t, so they stay in hospital, costing huge amounts of money)

dragon – Member

It’s never free though is it, you’ll pay one way or another.

Yup, and (on average) you’ll almost certainly pay more for private cover. The affordability argument doesn’t survive contact with the costs of the alternative.

dragon – Member

Now we can keep people in an undead state for years

Pretty uncommon- but yep, there’s a wider issue here where we’ve always taken then approach of keeping people alive, for longer. But we’re long past the point where we can keep people alive for too long. It’s not specifically an NHS issue, but it’s obviously one that affects it severely. But we haven’t even resolved the right to die, let alone the decision of when treatment is the wrong option, which is just massive.

Modern medicine is expensive. The fix they did on my hip didn’t exist even a few years ago, I’d have had a halfhip replacement with a pretty terrible longterm prognosis- but it’d be cheap. Instead I have a leg that is basically just a leg, should last as long as I do and can do whatever I want (unless mtbel wants to tell me I’m wrong and I should get a different leg!). But the surgery was more expensive, the training more involved, and the amount of physio and aftercare was massively higher (not because the surgery needs more physio, but because it makes it worthwhile). Expensive.

But if you’re ever thinking “I pay a load into the NHS, what do I get back”, maybe I’d have said the same thing 5 minutes before I bust my leg! Your tax doesn’t buy a product, it essentially buys insurance and trust me, it’s better to be able to say “I put more into the NHS than I take out” than the opposite.

The A&E Crisis is a good example of the challenge the NHS faces. Much of the recent commentary and proposed remedies by Trusts hasn’t been built off a detailed analysis of their own readily available data. The result of this is that the “problem” some Trusts are trying to solve is the wrong one, and the focus on the managing the associated root causes is in most cases just a waste of money and staff time.

This is one of the most detailed analyses I’ve seen and is built off the NHS’ own data.

http://blogs.deloitte.co.uk/health/2015/01/a-winters-tale-whats-really-causing-the-ae-crisis.html

“This suggests that solving the problem of availability of beds is not an A&E problem. It is a whole hospital problem that will only respond to whole hospital solutions. If the behaviour of the clinical community in the hospital is not coordinated with the demand from A&E (which it mostly isn’t) then there will be problems with finding the beds required for A&E patients (notwithstanding that most hospitals are making valiant efforts to try and resolve this challenge). Nevertheless, this last point is critical to attempting to resolve the A&E crisis. The biggest benefit might come from investments that don’t have anything to do with A&E. For example, better coordination of and more capacity in community care. But an even bigger gain should be possible with investment in real time bed management and better coordination of the flow through beds in the hospital, helping hospitals to improve control over the timing of discharges and avoid internal delays in the discharge process.”

We’ve heard a lot about “bed blocking” due to delays in arranging community care, but how much have we heard about internal delays in discharge management, even though is a bigger problem and fully owned by the Trusts?

http://www.bbc.co.uk/news/health-30828241

Mr Steel added: “It was the staff who said to me they would like someone to tell the outside world what was going on because I should imagine it has been happening before but nobody said anything.”

If NHS staff are going to play a game of politics, through their patients, then I’d expect support from the public to fall, accordingly.
NHS employees should stick to their day jobs, imo.

Our local NHS was running at +30% medically dischargable.

Budget is obviously in the wrong place, move it to the Council so they can ‘buy’ more care home beds and support staff.

And discharge planning/process was dire IME

Lack of quality staff plays a big part , esp mgt

Sorry just5minutes

But quoting bullshit reports by tory lickspittals will not cut it.

Sure the NHS uses loads of different types of gloves, does this mean you are volunteering to be operated on by a surgeon using marigold washing up gloves ?.

P.S. Virtually all NHS Buyers have M.C.I.Ps
https://www.cips.org/en-GB/Qualifications/About-CIPS-Qualifications/

@ b r
And capping salaries will just mean that you’ll not get new bright folk in.
Presumably bright folk who know nothing about the NHS, but are “bright” and are expect to learn and to become more effective

Far better if they didn’t just get paid more for been there longer.
Great lets not pay people more as they get better at their jobs

And also someone should remind the Govt/Senior Mgt that the only people they are bidding against are themselves – when it comes to staff (and temp staff). For example, who else employs a Radiographer (in any great number) than the NHS; or why pay bank staff w/e rates of pay?
Bank staff are substantive to their Trusts and are often offered extra money to work extra shifts to reduce the amout of extrnal agency staff required. This is usually considered a win/win.

samunkim – sorry but 600+ types of glove is proof of a lack of standard work / standard equipment – it’s nothing to do with “bull***t reports by tory lickspittals” because if you’d actually read the articles you’d have seen the source for the “waste” conclusion was actually the National Audit office.

As for M.C.I.Ps, if so many buyers are qualified, why is their such enormous waste in the procurement on goods and services? Are you seriously making a case that everyone including the National Audit Office are wrong in their evidence based conclusions of waste, and what are you comparing it to?

@ just5minutes

Yep the National Audit Office were wrong.
They outsourced they’re evidence gathering to a company called @uk

http://purchasing.uk-plc.net/buyerdotnet2/

who dragged in a University of Reading statistician who knew nothing about NHS Products and classified sizes as different items rather than different SKU’s
There actually only 30 or so gloves

Gloves Domestic
Gloves examination Latex non-sterile
Gloves examination Latex – Sterile
Gloves examination vinyl non-sterile
Gloves examination vinyl sterile
Gloves examination Synthetic non-sterile
Gloves examination Synthetic sterile
Gloves examination Gauntlet Length – Latex non-sterile
Gloves examination Gauntlet Length – Latex Sterile
Gloves examination Gauntlet Length Synthetic non-sterile
Gloves examination Gauntlet Length Synthetic sterile
Gloves examination Gauntlet Length vinyl – Non-sterile
Gloves examination Gauntlet Length vinyl – Sterile
Gloves surgeons latex
Gloves surgeons synthetic
Gloves surgeons latex – Indicator
Gloves surgeons synthetic – Indicator
Glove Surgeons – Under Gloves
Gloves surgeons latex – Enhanced Microsurgery
Gloves surgeons synthetic – Enhanced Microsurgery
Gloves surgeon Gauntlet Length synthetic
Gloves surgeon Gauntlet Length latex

The fallout from this still has not settled

http://spendmatters.com/uk/nhs-procurement-so-who-do-we-blame-for-the-dodgy-spend-data/

Hope this helps !!

@ just5minutes

Ohh and you may enjoy playing with this

http://ccgtools.england.nhs.uk/procurement/ProcAtlasOctober2014/atlas.html

Or you could just carry on taking anything the DailyTorygraph says as gospel

Oops.

It’s just as well we have NHS people on here, who can tidy up that messily torn new arse.

😆

Perhaps this could help

http://my.supplychain.nhs.uk/Catalogue/product/els037

TTIP should not be passed full stop.