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.

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?

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 want to see the money better spent within the NHS.

Bin PFI agreements & stamp on the political culture which spawed 'em. Put an end to misconceived notions of choice & competition within acute care. Stop contracting out for the mere sake of it (e.g. ISTCs, OOH GP cover – Gov really 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 very clear about what tax-funded state healthcare can & cannot 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 preventable 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).

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

No thanks I'll stick with England

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:

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.

Call me stupid but I think the comparison is perfectly reasonable. The general health, geographical and socio-economic conditions are broadly similar and to contend that a few islands make that much difference is ludicrous.

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

#
IME I would agree with that. I could list a number of instances where incompetence has cost £thousands/millions in my area alone, not to mention the huge number of additional middle management jobs created recently purely to fulfil the criteria for 'Trust' status. Not only are these 'created' jobs comparatively well paid but the incumbents have to justify their existance once in the post. Unfortunately, that invariably means increased admin. and/or additional 'procedures' for those below them, which more often than not are unworkable in pactice and may have a detrimental effect on the area which should be improved ie. patient care.

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