[Closed] will the tories cut the nhs budget if they get elected?

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whoever is elected will have to cut every budget, so I would expect so

I think anyone will but Tories are likley to privatise certain sections and pay for GP appointments.

I havbe not read their manifesto but the do what they want when in.

I'm not rich so I won't be voting for them.

yep chopped up and privatised all the way
after all the money hannahan has had off the medical insurance companies in the states i bet the rest of the gang want in on some of those incentives

bbc too i suspect will be chopped up

As TJ isn't here, I'll do it for him;

No! NO! We'll all die! Everyone will die!

BR above, however, speaks sense. Cuts are necessary. I just hope that those cuts are made in the places where cuts can be afforded without affecting necessary services. (There are many civil servants who are not necessary, IMO....)

I hope so.

The first thing I would do would be to end the final salary pension scheme for public sector workers.

I have it from someone who's quite senior in procurement for the nhs that labour have already got planned cuts in place. So yes the Tories will make cuts but so will anyone who get into power...

move to Scotland or Wales, health is devolved so the next Westminster Gov will only be able to affect England.

As someone who live in Scotland I'm afraid that cuts in the NHS will be inevitable here too. Some of the free care for the elderly is likely to go.

You should also bear in mind that the amount of money that the Scottish government gets to spend is a function of public spending in the UK as a whole, so any reduction in public spending from Westminster will reduce the amount of money available to spend in Scotland.

Britain is going to be so good under the Tories that I doubt there'll be any need for the majority of services that the NHS provides. I'm sure that's what Dave's been saying...

I suspect what will happen is increased privatisation in some areas which in healthcare always increases costs - so other areas will be cut to pay for this and that what the will do is increase budgets but at less than costs increase. I think we will see popular areas such as childrens health do well and unpopular such as treating junkies get cut badly ( even tho every £ spent on treating junkies saves £7 in other costs)

The NHS is in great danger from the tories - apart from one sensible policy ( but I bet it never makes it to reality) to remove the NHS from political control.

expect to be paying for GP appointments and expect a greater emphasis on a two tier NHS. Expect a pay freeze as well

Surely there is no need to cut budgets - we can just keep pending more than we receive in taxation at a rate of £2,000,000,000 a week?

thatscold - Member

I hope so.

The first thing I would do would be to end the final salary pension scheme for public sector workers.

Very nice. Jealous? it is a funded scheme and we pay for it.

Just 'cos your pension is rubbish why should you make mine rubbish?

we pay for it.

[b]We[/b] do indeed, TJ....we all do. 😉

Not sure about cutting NHS budget but they'll slaughter all firstborn babies fro shizzle.

9% of my salary. Its not unfunded.

people only have pension envy since that nigel lawson came up with the idea of pension holidays to liberate tall that saved pension dosh into the economy

now everyone is jealous of final salary schemes because successive torry/labour governments have raided the pension piggy bank to give themselves an economic/political short term boost

so private scehemes look so bad compared to final salary

Can I quote you on that TJ the nest time you complain about tax breaks on pension contributions? 😉

Introduce a flat £1 fee for everyone for prescriptions, and £10 to see your GP.

Gonefishing - I point out again that for every £ spent of taxpayers money subsidising public sector pensions there is £7 of taxpayers money subsidising private pensions.

Most public sector pensions are low.

I have a huge issue with me on less than the average wage subsidising rich peoples pensions. The bigger your private pension the bigger the state subsidy you get.

The NHS needs cutting. Middle managers, spin doctors, 5-a-day advisors, the multi billion pound computer etc. But NOT nurses, doctors or any front line workers. The Tories are probably going to be the gentlest with the NHS out of the big 3, they wouldn't DARE to renege on a manifesto pledge after lambasting Nulabour over their broken pledges on student fees, the EU referendum etc, not unless they fancy being one-term-wonders.

stevie - there is no significant slack in the way you describe. cuts will mean deaths - don't be fooled.

One of the major issues with the NHS is a lack of management both in quality and quantity. The NHS spends less on management than any comparable organisation.

Teh cuts will be stealth ones - ie inflation 2 % nhs budget increase 1.5% and a diversion of cash into privatisation which costs more - thus leading to cuts in other areas.

cuts will mean deaths - don't be fooled

Bullsh1t, TJ and you know it. As mentioned, there won't be deaths if things such as the "5 a day advisers" or many of the needless non-front line care jobs are cut. There is slack, there can be cuts without [i]DEATH! DEATH! DEATH![/i], so just get ready to accept it.

We desperately need to save money as a country. There are areas where those cuts can be made without affecting the vital services we all value.

For example, does Brent NHS really need a [i]a highly motivated individual to the post of Tobacco Control Alliance Co-ordinator[/i], especially at around £40,000 per annum?

As mentioned, there won't be deaths if things such as the "5 a day advisers"

If you take an incredibly short term view then yes, but isn't eating more vegetables proven to be a good thing which will actually cut deaths and NHS costs in the long run?

AS grumm says - every smoker costs thousand and thousands.

There is virtually no slack in NHS budgets. Cutting stop smoking advisors will result in more expense and more deaths as they are proiven to be effective and cost effective.

Its not rocket science.

Every smoke also contributes thousands! 🙂

That job is not a simple "stop smoking advisor", it's a needlessly overpaid non-job. One of many. A "stop smoking advisor" could not really be worth £40k a year could they? Just to dish out some nicorette and say nice things to people?

I'd rather see that £40k spent on real front line healthcare. Yes education is important, but it should not be better paid than those with real medical skills. In essence, TJ, I would sooner you had that money than some limp idiot with bad hair and a reedy voice waffling on in meetings! 😉

kimbers

people only have pension envy since that nigel lawson came up with the idea of pension holidays to liberate tall that saved pension dosh into the economy

Let's not forget that Gordon removed tax breaks on pensions, making pensions that were previously healthy go sour.

As for the NHS, yes, I expect they will make cuts, and I hope they do. I have temped in the NHS, and know a few people who work in it at the non-clinical end. If someone turns up with a quite ordinary workrate, they are hailed as being incredibly productive. GPs currently have a bonus scheme that means they get paid a fortune for making their patient's experience worse. Much like the council, sacking someone is incredibly convoluted, so a lot of people who don't want to be there are still on the staff due to the pension etc. I'm sure anyone going through the thing with a fine toothed comb would find lots of similar savings. And that would be the way to do it.

I think it goes without saying that the pension schemes of all public sector bodies need to be looked at. Private pensions need to be improved, and public pensions need to be on a par. Same goes for sick pay, fringe benefits etc. Public and private jobs should be directly comparable.

Ultimately, to me the answer is pretty obvious - we keep tweaking this and that with the NHS, but there are countries which have excellent healthcare systems. The most sane option would be to copy them.

The problem is if the next government (whoever they are) simply cut all budgets by x% and the management simply close / delete more or less at random.

t taken CFH - however the scope for cuts that don't affect frontline services is virtually zero. Remeber there has been a 3% "efficiency" saving made annually for years in most budgets.

Yes some money could be saved - a % or two - simply not enough to be significant. We still don't spend enough on our healthcare - still below the EC average

Good - can we have private sector wages as well? As an experienced shop floor nurse I get £12 per hour - thats degree educated ( at my own expense) and 30 yrs experience. £12 per hour. £24 000 pa.

Ultimately, to me the answer is pretty obvious - we keep tweaking this and that with the NHS, but there are countries which have excellent healthcare systems. The most sane option would be to copy them.

Which countries should we copy? Please tell?

I reckon it's a fair bet that they'll follow the line that they did when they last took over government

No - not a concerted effort to destroy the working classes, although they may try that again

Tory budgets
http://www.bbc.co.uk/politics97/budget97/background/bud1979_92.shtml

One of the major issues with the NHS is a lack of management both in quality and quantity. The NHS spends less on management than any comparable organisation

TJ you must work for a different NHS to me as there are far too many middle mangers who have now Idea what they are doing – most don’t have clinical backgrounds and tend to forget that we deal with people not tins of beans.
TBH cuts are happing already and have been for some time – vacant posts not be filled – beds & wards been closed – specialist services disbanded or amalgamated into generic teams
All the while the number of managers continues to increase
Over the last year I have lost about 2 visits per day due to increased data entry on our patient information system – the irony being this system if for payment by results i.e. the trust gets money per visit from the Primary Care Trust

The NHS needs cutting. Middle managers, spin doctors, 5-a-day advisors, the multi billion pound computer etc. But NOT nurses, doctors or any front line workers

The way the changes to the way doctors were paid was a disaster though, and accounted for a big chunk where the extra NHS funding went.

Don't worry, Cameron's going to mend society, so sorting out the NHS will be a trivial problem.

TandemJeremy

Good - can we have private sector wages as well? As an experienced shop floor nurse I get £12 per hour - thats degree educated ( at my own expense) and 30 yrs experience. £12 per hour. £24 000 pa.

Yes. The current idea seems to be that people in the public sector get paid a bit less, but get to take the odd sicky, generally slack a bit whilst being immune to being sacked, and get a very good pension. I'd much rather the public and private sectors were on an even footing, so it's clear whether or not the public sector is paying the going rate.

TandemJeremy

Which countries should we copy? Please tell?

I have no idea. Quite a few countries beat us in terms of life expectancy at 65 and cancer survival rates.

The bigger your private pension the bigger the state subsidy you get.

Can you explain to me what state subsidy goes into my pension. As far as I can tell the only money that goes into mine is from the money that I earn. These contributions are, like your 9%, not liable for taxation. Unlike yours however there is no employer contribution. So where is the subsidy?

CF you are taking a very shortsighted view of healthcare spending. All you seem to be doing is saying that by reducing spending in one location that money will be saved without looking at the potential consequences of those cuts and what that may mean cost wise in the longer term. It's analogous to thinking that by not spending money money on servicing your car your are saving money when in actual fact there is a risk that you are merely inviting a much larger cost at a later date.

So Tron - which countries healthcare systems should we emulate?

USA - twice as expensive for only 70% of the population coverd

Germany pretty good health service. Cost about 20% per head more than the NHS with admin costs twice as high

Dutch - costs about 15 % more per head than us and many folk end up paying significant amounts for care - it cost my sister £3000 to have each of her children.

France - see germany. Much the same.

Etc etc.

So I'd like to know what countries health service you think provides better care for less money.

Tron - of course some countries have better outcomes - they spend more on healthcare. Its not rocket scinece. we have comprehensive care for what is still well less than 10% of gdp. The average in the EU is 12% of gdp. USA is 16 - 18% of gdp.

Spend more and get better healthcare. The NHS does more for less than any other comparable system and our admin overheads are very low by comparison.

Good - can we have private sector wages as well? As an experienced shop floor nurse I get £12 per hour - thats degree educated ( at my own expense) and 30 yrs experience. £12 per hour. £24 000 pa.

At the risk of sounding harsh - if you've a problem with what it gets paid then why don't you consider changing career? It's not like you could have went into it with any other salary expectation than that.

I think nurses clearly do a very valuable job but unfortunately for those following that career path the balance of supply and demand seems to still be such that there is no [b]need[/b] for nurses to be paid more (i.e. while there are people willing to do it for the current wages).

Most people (including me) would agree that a job like that is valuable enough to society to be worth paying more but it's market forces, not public opinion, that decides these things. It's not like the government has spare cash to throw about just because they think people deserve it. They think the money is better server to spend on their expenses and wars in foreign climes.

I haven't done work for the NHS for years now, but when I did a few years back I found it quite alarming just how wasteful they were in the areas I was involved in (IT).

Gone Fishin

Can you explain to me what state subsidy goes into my pension. As far as I can tell the only money that goes into mine is from the money that I earn. These contributions are, like your 9%, not liable for taxation. Unlike yours however there is no employer contribution. So where is the subsidy?

You get tax relief on the money you put into pensions. Which I suppose may be considered as a subsidy. I consider it as a small sliver of sanity.

epic steve - I have no issue with the salary levels - so long as we continue to have decent terms and conditions.

as for market forces - why do you think we import thousands of nurse for abroad each year - because too few UK residents complete their training. There is a serious shortage of nursing staff in the UK which is going to get worse. we train less each year than retire or leave the profession. Market forces don't work with a monopoly.

As for the pension subsidy = please remember that the tax relief is 7 times the cost to the taxpayer than the direct subsidy to the public sector pensions

We have all lived beyond our "real" earnings in the last bubble. Now is the time of reckoning, whichever party gets in will have to cut everywhere until spending and earning are balanced again.
A second point, don't confuse how much you spend on something with how good it is. That has been one of the most expensive errors of recent times, extra spending but with no reform.
We can either do it for ourselves or let the IMF do it for us. Either way it will hurt.

TandemJeremy - Member

Tron - of course some countries have better outcomes - they spend more on healthcare. Its not rocket scinece. we have comprehensive care for what is still well less than 10% of gdp. The average in the EU is 12% of gdp. USA is 16 - 18% of gdp.

They may well spend more on healthcare, and so should we, when we can afford it. The problem is that the extra money we've chucked at the NHS hasn't seemed to have as much impact as it might have.

On the other hand why do you think nurses have to be from the uk (although I'd happily admit I'd prefer it)? If the nursing posts are filled with qualified staff then there isn't really much the NHS as an employer can do about it.

Gordon Browns speech about British jobs for British workers was bollocks and he knew it at the time - unless he takes us out of the EU it's not something he can deliver.

tron - it has made a huge difference - and much of it has gone on undoing the damage of previous times.

waiting time, improved treatments, etc etc

epic steve - its not EU nurses - we are stripping nursing staff from third world countries and giving nothing in return. One of the carribean islands had to close its only ITU after all its staff were recruited to work in the UK. Zimbabwe has lost a significant proportion of its nursing staff to the UK.

Other EU nurses don't come to work here much

The current idea seems to be that people in the public sector get paid a bit less, but get to take the odd sicky, generally slack a bit whilst being immune to being sacked, and get a very good pension.

Interesting thought – certainly not true in my part of the NHS – I’d love to have the time to take a sick day – but these just not the time – I work flat out all day every day – don’t have time for coffee breaks or lunch - no matter how stable my clients (patients) are I never know what going to find when I knock on the door – As one of the more experienced members of the team I get to see the more complex, unstable and unpredictable clients – Currently I have 4 clients who are actively suicidal - several who live in desperate poverty and have fairly advanced dementia – a bunch who have aggressive and demanding relatives. There are few resource, no inpatient beds and limited placement in the independent sector – My main skill is plate spinning
For this emotionally and physically demanding job, where I have a legal responsibility for peoples lives I get paid just over 30K pa – (Top increment Band 6 Nurse)

On the other hand why do you think nurses have to be from the uk (although I'd happily admit I'd prefer it)? If the nursing posts are filled with qualified staff then there isn't really much the NHS as an employer can do about it.

I suspect what happens is other countries pay a fair whack to train nurses, who after a few years experience up sticks and come to work in the UK. So effectively we're robbing poorer countries of nurses by not training enough of our own.

I know a lass who's a nurse, and it's not a job I'd ever choose, so I can see why we're short of them. The shift patterns are terrible (ie, all over the place) and you have to calculate dosages etc. despite that. In fact, I'd be utterly amazed if people don't die because of the way shift patterns are arranged.

epic steve - its not EU nurses - we are stripping nursing staff from third world countries and giving nothing in return.

Not relevant. If the NHS can get qualified nurses from anywhere then they will, and they're not in a position to stop individual recruitments just because it's causing problems with the country of source.

Personally I'd prefer our doctors and nurses to be from the UK, but the NHS, like everyone else, isn't in a position to discriminate.

For this emotionally and physically demanding job, where I have a legal responsibility for peoples lives I get paid just over 30K pa – (Top increment Band 6 Nurse)

I wouldn't do that job for those wages, but as long as people will (no matter where they come from) the salaries aren't likely to improve.

I'm constantly amazed that I have to defend the fact that I get an average pension for being a nurse.

Just because private sector pensions have been messed up by those same financial wizards responsible for our current mess, I should somehow get hammered too?

The politics of envy aimed at ...nurses....? Really?

The same financial wizards who insist that they must be able to pay big bonuses in order to retain the best staff, but we can pay any old shite for nurses cos there's lots of them?

It wasn't like that in my day; we were told that we'd never be rich if we chose to be nurses, that we couldn't go on strike, that we would lose our registration if we got caught drunk outside work, but that we would get an average pension...

crikey - there are imo two aspects to this.

One is there has been a moral panic stirred up by the right wing press and the tories about "unaffordable public sector pensions" most of which is utter rubbish and the other is simply the politics of envy.

Most public sector pensions are around £10 000 pa and many less. Hardly riches.

[i]The same financial wizards who insist that they must be able to pay big bonuses in order to retain the best staff, but we can pay any old shite for nurses cos there's lots of them?[/i]

Well said.

Although I'd go further - I'd put those same financial wizards in scrubs (HCA on an understaffed MAU, say), to see if they could handle it. 😈

Just because private sector pensions have been messed up by those same financial wizards responsible for our current mess, I should somehow get hammered too?

Unfortunately the people arguing here for Cuts to the NHS or pension schemes are those with a comfortable living who don't need to worry about things like that, but want to see cuts because they desperately want a tax cut at some point in the life of the next Government regardless of the financial difficulties.

And if you don't fit that criteria and you are still arguing for cuts...then you are bit thick.

Its always the case that certain people will point out faults with the NHS, be it too many managers, pensions etc, that its swimming in funds, and that their answer to resolve these issues is to cut funding(theres that tax cut again)we've been down that road with the previous tory Governments and look what happened.

I want to see the money better spent within the NHS.

TJ said-stevie - there is no significant slack in the way you describe. cuts will mean deaths - don't be fooled

Utter rubbish Jerry. My wife is a nurse and the profligacy within the NHS that she sees is beyond belief. For instance-they pay a local catering firm to supply milk. That catering firm buy from the local Texaco Spar-the dearest milk in Brighton-and charge the NHS £5 for a 2 litre of milk that costs £1.19 at Tesco. Times that by millions of litres a day across the NHS. Cutting mindless waste will not cause deaths.

Yes there is mindless waste - but its such a small % that eliminating it all will have no effect worth mentioning. Thats the issue. Not that the waste is not there - or that it many thousnds of ponds but its such a small % of the NHS budget that it cannot give the amount of savings people want.

epic steve - its not EU nurses - we are stripping nursing staff from third world countries and giving nothing in return. One of the carribean islands had to close its only ITU after all its staff were recruited to work in the UK. Zimbabwe has lost a significant proportion of its nursing staff to the UK.

100% RIGHT Jerry. South Africa, a country that has 20,000,000 folk with HIV loses loads of desparately needed nurses to the UK. They NEED them there. We should train our own jobless people and start paying student nurses again to make it an attractive proposition..

Yes there is mindless waste - but its such a small % that eliminating it all will have no effect worth mentioning. Thats the issue. Not that the waste is not there - or that it many thousnds of ponds but its such a small % of the NHS budget that it cannot give the amount of savings people want.

Nulabour wasting umpteeen £billions on the NHS computer is hardly insignificant, is it? They have wasted £26,000,000,000 on failed IT programmes mate, and should be hounded from office for that profligacy alone.

 

On th4e IT system I totally agree with you - cancel it now

Nulabour wasting umpteeen £billions on the NHS computer is hardly insignificant, is it? They have wasted £26,000,000,000 on failed IT programmes mate, and should be hounded from office for that profligacy alone.

Yes. There should generally be a ban on the use of private sector consultants on government IT projects. You could employ a load of bloody good developers, system architects etc. in house for way less money than employing terrible consulting firms like EDS etc, who are basically employed due to their ability to play golf with high up executives. It is just a way to get stuff off the balance sheet that we end up paying way more for, and getting terrible quality work, by people who do the minimum to fit a poorly defined specification that is written by non-technical managers who understand neither computer systems, nor the work that is being done by front line workers. It's essentially what always happens when IT consultants come into somewhere that has no IT knowledge of its own, everyone gets ripped off (and the consultants probably don't have much fun either to be honest).

As a bonus, it'd stop them just saying today '99 billion quid project, starting next week', as if they really wanted to do something big, they'd need to consider hiring requirements, and generally plan projects properly.

Joe

[i]I want to see the money better spent within the NHS.[/i]

Bin PFI agreements & stamp on the political culture which spawed 'em. Put an end to misconceived notions of choice & competition within [i]acute[/i] care. Stop contracting out for the mere sake of it (e.g. ISTCs, OOH GP cover - Gov [i]really[/i] shot themselves in the foot with that one...) and concentrate on improving capacity (run hospitals at 80% - not 100%!) & staffing. Improved capacity and staffing = less things go wrong, money saved. Improve screening programmes. Stop spending money on bludy freeloading management con.sultants (esp the likes of McKinsey - the like of whom have much to answer for as regards the IT white elephant). Sort out patient social/discharge issues - why do we have elderly patients sat around, with nowhere to go? Be [b]very clear[/b] about what tax-funded state healthcare [i]can[/i] & [i]cannot[/i] do. End the top-down DoH control freak culture in favour of better, localised management. Stop peeps abusing ambulances as taxis. Have a PROPER debate about the health/social costs of alcohol - frankly, wards are overrun with all manner of [i]preventable[/i] stuff.*

(* yup, I'll happily forfeit the tax revenue from alcohol sales - in exchange for seeing fewer jaundiced patients - their bellies swollen with ascites, their brains bombed out and hot blood pouring out their arse).

[i]move to Scotland or Wales, health is devolved so the next Westminster Gov will only be able to affect England. [/i]

[url= http://www.telegraph.co.uk/health/healthnews/7031551/Scotlands-health-not-as-good-as-Englands-despite-higher-proportion-of-doctors.html ]No thanks I'll stick with England[/url]

Of course they'll cuts be made just hope it's in sensible areas and for the pension jealous, our pensions have already been reviewed. Luckily for me I've been in long enough to have it protected.

Let's see what Mr Cameron says:

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So that's it settled, clearly there will be cuts 😉

No thanks I'll stick with England

Comparing the cost of health provision in NE England with Scotland just because they have approximately the same population size is abject stupidity. The difference in geography alone, and the need to cater for the islands, would make the Scottish health service a lot more expensive to run.

For the patient it's not the cost but the service that they worry about, no point in having billions if you care is shit.

And patients have no interest in bogus choice. What they want is good care locally. Not the Choice to go to a hospital in anther town.

It's also the lack of competence of so-called 'managers' in the NHS, people promoted way above their level of competence. A case in point; my soon-to-be sister-in-law was an anaesthetist at the Princess Margaret Hospital in Swindon. A former cleaner was promoted up to the level where she was managing Tess and the others on her team. The situation became so bad that Tess left and took a huge pay cut just to get away from that hospital. Five other staff members left around the same time, due to stupidity like giving staff their shift rotas, then the person concerned coming in to do their next shift only to find it had been changed in their absence, and that staff member being told they should have logged onto the hospital's internal website to check to see if their shift had been changed! I mean, how the fracking hell are you supposed to work with idiots like that? There's no way that I would expect to have to check everytime I go off shift to see if my rota had been changed behind my back with no consultation. That is just incompetent, and that is happening all over the NHS. That is where cuts and savings need to be made, and I have close friends in the NHS who can back me up.

Comparing the cost of health provision in NE England with Scotland just because they have approximately the same population size is abject stupidity. The difference in geography alone, and the need to cater for the islands, would make the Scottish health service a lot more expensive to run.

It's also the lack of competence of so-called 'managers' in the NHS, people promoted way above their level of competence.

Woody - you are wrong about the highlands and islands creating extra cost. Think how difficult it is to meet the 8 min ambulance call? Think how difficult district nursing is to do, etc etc.

Call me stupid

No need, as I think your response has already made that clear... 😛

I cant really see why a significant cut in budget need have any negative effects!

I mean, at the moment, we're paying approx 1 million people benefits to stay at home, whilst at the same time we're paying people to do menial tasks such as picking up litter and clearing snow - there's a huge variety of tasks taking place on the NHS estate that could be done by people not otherwise employed.

And as for the hospitals with a £500k laundry bill - let me show you around our new facility - "Her Majestys prison and corrective laundry unit"

It's all very well adopting the Daily Mail style 'sack all the managers' position, but its like asking Tesco to sack all their managers and run the stores with checkout girls only.
The NHS is a massive complex organisation, and needs to be managed at all levels. If we sack all the managers, the things they do still need doing, and the much lauded frontline staff like me end up trying to juggle clinical roles with some management tasks and do neither very well.
I need my management so I can do my job...

The NHS has lower managerial costs than the other EU healthcare systems - partly because of the simple funding, partly because it does not have enough manager.

some of them are total rubbish and waste money but I am like Crikey - I want decent management to get everything in place so I can do my job. I don't want to have to do the managers jobs as well

Zulu-Eleven - Member

I cant really see why a significant cut in budget need have any negative effects!

Well I can and so can everyone who works in the NHS. Eliminate all waste ( impossible to do btw) and you will save a % or two. Cut 10% of the budgets and people will die. Its simple.

Laundry - can you imagine the logistical difficulties in getting erh laundry to the prisons and back? Can you imagine how much extra linien would be required if laundry is offsite? How much would it cost to build a new laundry in the prison?

TJ - a number of hospitals already use off site central laundry facilities, thats just one example!

Yes - but they are already built and the stock is available. So to save the money of a few laundry staff - running costs - you want to make a huge capital spend

just showing how little of an idea you actually have of the reality of the situation.

The NHS is actually a very lean organisation as can be seen from thefact its costs are so low.

Thats the reality rather than the right wing dogma and fantasy

Oh, TJ - I'm sure you'd agree that in the overall cost of building a new prison facility, a laundry unit isn't going to cause a major issue, especially given how much we'll save by selling the old prison sites for brownfield housing!

It's clear that one of the major issues with PFI is its use to create "off the books" investment that did not appear on the government balance sheet to get round Gordon's fiscal rules!

Jerry-justify this-

£30,000 each a year for 'Eating more Veg' advisors
Cosmetic boob jobs on the NHS
£40,000 a year each for 'Arts Co-ordinators'
£30,000,000 a year removing tattoos
£9,000,000 a year on management consultants
£2,000,000,000 a year on foreign 'health tourists'
£40,000 on a 'Patient Experience' questionaire

This kind of waste is almost criminal. Then there's crap like this-

An NHS trust, almost £5million in the red, gave a former director a £243,000 pay-off, after working for them for only three weeks. Dr Iheadi Onwukwe was put on "gardening leave" for three years after a dispute with a senior colleague. Then he was given his golden handshake, which could have paid for 300 cataract operations or given more than 40 patients life-saving heart bypass surgery. The same trust gave hospital chief executive Annette Sergeant a £231,000 pay-off. Ms Sergeant, who was earning £135,000, was slammed in a Healthcare Commission report. After going sick, she negotiated her deal. (Source: Daily Mirror, Jan/07)

This is the sort of cuts we need, efficiency cuts. There's bliions of pounds to be saved or spent on the sick instead of being flushed down the swanny..

Sources?

There are no cosmetic boob jobs on the NHS. Same with tattoo removal.

Health prevention such as the five a day saves money - repeatedly proven. Arts co ordinators - dunno what you are on about.

There is no such thing as a health tourist. We treat EC residents and other entitled people for free as we get free treatment in other EC countries. People from outside the EC should be charged. 2 billion a year? balderdash

Management consultants - unjustified for sure in some cases. Doewn to a shoitage of internal management.

patient experience questionnaires - how else do you find out what patients experience is?

Payoffs - seems unreasonable on the surface but who knows the whole story.

this sort of thing remains a tiny tiny % of the total budget.

Thats what you dogmnatic guys fail to realise. There simply is not the slack that you like to pretend. It just is not there.

Boob Job on NHS- http://www.newsoftheworld.co.uk/news/278636/Amanda-Ryan-gets-boob-job-on-the-NHS-at-just-17-to-improve-her-temper.html

Tattoo removal on NHS- http://www.theyworkforyou.com/lords/?id=2006-10-25b.1207.3

Health tourism- http://www.telegraph.co.uk/news/uknews/3343633/Health-tourists-leave-tens-of-millions-in-NHS-bills-unpaid.html