Live Labour broadcast on the future of the NHS

exiledinboro said:
A perfect example of why a powerful opposition is and does still matter

Basically we have 2 parties that are in favour of privatising the NHS now so what we celebrating, Laughing?
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I wasn't celebrating anything exiled, I was posting it for anybody who wanted to watch it. I assumed there would be some interest.
 
I haven’t even heard it but i can imagine starmer is cut from the same private public partnership cloth as blair.
 
I wasn't particularly impressed. I could spin it a bit, but don't really feel like it. Ultimately will we get more or less for our money. You can't help but think less. If it addressess the issues today, then fair enough, but I can't see any plan to roll it back.
 
Without watching the video but being part of a finance team in the NHS I have experience if privatisation of services. My view is that at times it makes sense. We don't need NHS employees in every hospital doing routine tasks like processing invoices so having a single, central company don't that makes sense. That company being private or NHS run doesn't make much difference. It's probably cheaper private because staff will get paid less and they won't have the NHS benefits like pension and sick pay etc. Whether that is a good or bad thing is up to you.

When it comes to clinical services it is a bit different. An NHS service will tender based on the cost of delivering the service. A private company will tender based on a price they will accept. It could cost more to do it privately but they will accept a loss because they know that once the NHS service is gone then it being recommissioned will never happen so they can then bump up their prices and there is no competition.

Other times a private service like opthalmology already has some specialist equipment that the NHS doesn't. It makes sense for them to run the service because the cost is much lower than being the NHS service to also buy the equipment.

There is obviously the huge issue about profits being taken out instead of reinvested. The NHS is already running on minimum service provision so if a private company can do it cheaper and pay out dividends then they must be cutting corners.

I'm summary, some privatisation is good, others are bad. Too much nuance to definitively say which ones and impossible to do it without some privatisation.
 
Nano said:
Without watching the video but being part of a finance team in the NHS I have experience if privatisation of services. My view is that at times it makes sense. We don't need NHS employees in every hospital doing routine tasks like processing invoices so having a single, central company don't that makes sense. That company being private or NHS run doesn't make much difference. It's probably cheaper private because staff will get paid less and they won't have the NHS benefits like pension and sick pay etc. Whether that is a good or bad thing is up to you.

When it comes to clinical services it is a bit different. An NHS service will tender based on the cost of delivering the service. A private company will tender based on a price they will accept. It could cost more to do it privately but they will accept a loss because they know that once the NHS service is gone then it being recommissioned will never happen so they can then bump up their prices and there is no competition.

Other times a private service like opthalmology already has some specialist equipment that the NHS doesn't. It makes sense for them to run the service because the cost is much lower than being the NHS service to also buy the equipment.

There is obviously the huge issue about profits being taken out instead of reinvested. The NHS is already running on minimum service provision so if a private company can do it cheaper and pay out dividends then they must be cutting corners.

I'm summary, some privatisation is good, others are bad. Too much nuance to definitively say which ones and impossible to do it without some privatisation.
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great post, put into words my thoughts that I was too lazy to fully articulate.
 
Nano said:
Without watching the video but being part of a finance team in the NHS I have experience if privatisation of services. My view is that at times it makes sense. We don't need NHS employees in every hospital doing routine tasks like processing invoices so having a single, central company don't that makes sense. That company being private or NHS run doesn't make much difference. It's probably cheaper private because staff will get paid less and they won't have the NHS benefits like pension and sick pay etc. Whether that is a good or bad thing is up to you.

When it comes to clinical services it is a bit different. An NHS service will tender based on the cost of delivering the service. A private company will tender based on a price they will accept. It could cost more to do it privately but they will accept a loss because they know that once the NHS service is gone then it being recommissioned will never happen so they can then bump up their prices and there is no competition.

Other times a private service like opthalmology already has some specialist equipment that the NHS doesn't. It makes sense for them to run the service because the cost is much lower than being the NHS service to also buy the equipment.

There is obviously the huge issue about profits being taken out instead of reinvested. The NHS is already running on minimum service provision so if a private company can do it cheaper and pay out dividends then they must be cutting corners.

I'm summary, some privatisation is good, others are bad. Too much nuance to definitively say which ones and impossible to do it without some privatisation.
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Do we want employees to be paid less whilst working in the NHS?
 
Corcaigh_the_Cat said:
Do we want employees to be paid less whilst working in the NHS?
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This question is politics in a nutshell. On the face of it the obvious answer is of course not. If were operating in a world where we had an unlimited budget then we'd pay everyone the most that we could but we're not. We are constrained by our budget so we have to make decisions.

A private business, like Tesco, have the decision between replacing staff with self checkout machines. For them their goal is maximising profit so saving costs achieves that. In the NHS the goal is treating patients so we look to prioritise services that increase the opportunity to do that.

One of the ways is by reducing costs in one area (cleaners for example) so we have more to spend on clinical staff. It's not as clear cut as saving money is good. I've personally argued against outsourcing at times because cheaper isn't always better. It's about value but the NHS, because of the Agenda for Change pay structure pays more than the market rate for some roles (and way below for others). Does it make sense for the tax payer and patients to overpay for those things at the expense of clinical staff? That's a political question with no right answer unless the answer contains "with unlimited funds".
 
Nano said:
This question is politics in a nutshell. On the face of it the obvious answer is of course not. If were operating in a world where we had an unlimited budget then we'd pay everyone the most that we could but we're not. We are constrained by our budget so we have to make decisions.

A private business, like Tesco, have the decision between replacing staff with self checkout machines. For them their goal is maximising profit so saving costs achieves that. In the NHS the goal is treating patients so we look to prioritise services that increase the opportunity to do that.

One of the ways is by reducing costs in one area (cleaners for example) so we have more to spend on clinical staff. It's not as clear cut as saving money is good. I've personally argued against outsourcing at times because cheaper isn't always better. It's about value but the NHS, because of the Agenda for Change pay structure pays more than the market rate for some roles (and way below for others). Does it make sense for the tax payer and patients to overpay for those things at the expense of clinical staff? That's a political question with no right answer unless the answer contains "with unlimited funds".
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The goal for the privatised sector of the NHS is also maximising profit. They drive down wages, which has a knock on in increased demand on the NHS.

There should be a narrowing of the pay gap within the NHS, train more clinical staff to increase their availability.

Long term solutions are required, not short term fixes such as outsourcing.
 
Corcaigh_the_Cat said:
The goal for the privatised sector of the NHS is also maximising profit. They drive down wages, which has a knock on in increased demand on the NHS.

There should be a narrowing of the pay gap within the NHS, train more clinical staff to increase their availability.

Long term solutions are required, not short term fixes such as outsourcing.
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I don't disagree but it's simply not the case of private being bad. There are some things that don't need to be NHS and can be run more efficiently by a private company. It wouldn't make sense to have the NHS making its own version of Microsoft Office so we use that and pay the licence. We don't build our own buildings, we don't deliver our own mail etc. What is required to be a NHS run service and what isn't is often blurred by what has been done historically. There are companies with radiology equipment that the NHS doesn't have that can do those scans that the NHS can't. Does it make more sense to spend the fee for them to do it or to train staff, but equipment and do it in the NHS (even if it is the same cost). That money can be better spent elsewhere.

Mr Sheppey said:
I worked for the NHS for 12 years before retiring and every time a part was privatised it was brought back into the NHS later on because it gave worst service at a higher cost.
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That's only one side of the coin. If every NHS service that didn't make a profit handed back the contract there would be no more services running. Pretty much every hospital is operating at a significant loss. Services can not survive if they only received the tariff. We talk all the time about an under funded NHS and this is one of the consequences. The difference is that if the private company says they don't want to run a service anymore then the NHS has to take it back on and carry that loss. The services that are being run well privately you don't even notice and they aren't coming back.
 
exiledinboro said:
If 40,000 nurses quit the NHS in 2022 and thousands of clinical positions remain unfilled then transferring NHS staff to private contracts that will have worse pay, less holiday entitlement and sick pay. Less likely to be unionised and pension contributions seems absolutely insane and will almlst certainly mean even more people leaving the NHS

If you can't fill the NHS jobs now which is clealry a problem you don't transfer them to private contracts

Clinicians are voting with their feet and getting out. I hear Australia and arab nations are advertising for our staff

I don't have a problem with some things being privately run as you say but that's what we have now. The NHS software is built by technology providers so that's not the issue. Although £10 billion was spent by private corporations to try to integrate NHS programmes and it was eventually abandoned

The clinical side is the problem which Labour is nit addressing
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That is a knotty problem. Ready available, trained staff are hard to come by, I assume. Not many politicians would be saying right now, let's increase immigration. It just wouldn't be popular despite it being a good solution.

I don't know. The nhs, once the pride of Britain is just so depressing now.
 
Nano said:
Without watching the video but being part of a finance team in the NHS I have experience if privatisation of services. My view is that at times it makes sense. We don't need NHS employees in every hospital doing routine tasks like processing invoices so having a single, central company don't that makes sense. That company being private or NHS run doesn't make much difference. It's probably cheaper private because staff will get paid less and they won't have the NHS benefits like pension and sick pay etc. Whether that is a good or bad thing is up to you.

When it comes to clinical services it is a bit different. An NHS service will tender based on the cost of delivering the service. A private company will tender based on a price they will accept. It could cost more to do it privately but they will accept a loss because they know that once the NHS service is gone then it being recommissioned will never happen so they can then bump up their prices and there is no competition.

Other times a private service like opthalmology already has some specialist equipment that the NHS doesn't. It makes sense for them to run the service because the cost is much lower than being the NHS service to also buy the equipment.

There is obviously the huge issue about profits being taken out instead of reinvested. The NHS is already running on minimum service provision so if a private company can do it cheaper and pay out dividends then they must be cutting corners.

I'm summary, some privatisation is good, others are bad. Too much nuance to definitively say which ones and impossible to do it without some privatisation.
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With the greatest respect NHS procumbent is naive in the extreme and is completely spanked by the private providers who put all their efforts into winning the tender and nil in delivering.Often those involved in the original decision have buggered off,leaving beleaguered NHS staff to pick up the pieces.
 
Anyone mention the huge interest rates being paid out of the public purse to private lenders when the public private partnership took our hospitals out of public ownership into the private sector? Many of our hospitals are mortgaged from the private sector.
Dont pay.
Dont stay.
 
SNEEKERS said:
With the greatest respect NHS procumbent is naive in the extreme and is completely spanked by the private providers who put all their efforts into winning the tender and nil in delivering.Often those involved in the original decision have buggered off,leaving beleaguered NHS staff to pick up the pieces.
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There is a big difference between tendering for a commissioned clinical service and a non-clinical good/service. The NHS is hamstrung in that it can only state what it will cost to run that service which is based on reality but the private company can just give a price that they will accept and that doesn't have to be based on reality. The commissioner has to decide if the bid is realistic or not but it can look realistic on best case scenarios quite easily.

There is also the situation that if there is no NHS bid but there is a private one then the option is commission it or don't. You can't force the NHS to do it if nobody has the facilities or staff.

It's very complicated and my gut would always be to avoid privatisation unless there is no option. The realistic situation is that we have had a decade of underfunding and decimating of services so if we want to catch up at have to expand capacity rapidly and we can't do that by Judy asking NHS staff to work harder.
 
exiledinboro said:
If 40,000 nurses quit the NHS in 2022 and thousands of clinical positions remain unfilled then transferring NHS staff to private contracts that will have worse pay, less holiday entitlement and sick pay. Less likely to be unionised and pension contributions seems absolutely insane and will almlst certainly mean even more people leaving the NHS
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but moving nurses into the private sector is not what Nano was proposing. Nano specified non-clinical, by that it's all the ancillary stuff that an org needs, but not anything to do with the end purpose of the NHS, looking after patients and making them better. Back office stuff, infrastructure projects, cleaning and catering services, things that are not core business could all be done better and cheaper. But I don't think Nano is advocating moving a single nurse out to the private sector.

The government needs to make the sector a better proposition for people to join....but lets be honest it isn't by accident that it has become an Industry where we don't have enough skilled people to fill the role. It was Tory ideology to stop people working in the NHS, disincentivize them, so that it broke.
 
exiledinboro said:
Which is what is already happening now so how have you improved patient care?

It's tinkering around the edges when you need to fill the vacancies
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It's not, if you read the rest of my post I talk about how people have been disincentivized from joining. The government strategy was to break it. I suggest we stop breaking it, make it a worthwhile career again, get the vacancies filled.
 
There is little hope. When senior labour figures are financed by private healthcare companies and when the Labour party are urging the Tories to use the private sector more for NHS patients, there is little hope.
 
Nano said:
I don't disagree but it's simply not the case of private being bad. There are some things that don't need to be NHS and can be run more efficiently by a private company. It wouldn't make sense to have the NHS making its own version of Microsoft Office so we use that and pay the licence. We don't build our own buildings, we don't deliver our own mail etc. What is required to be a NHS run service and what isn't is often blurred by what has been done historically. There are companies with radiology equipment that the NHS doesn't have that can do those scans that the NHS can't. Does it make more sense to spend the fee for them to do it or to train staff, but equipment and do it in the NHS (even if it is the same cost). That money can be better spent elsewhere.


That's only one side of the coin. If every NHS service that didn't make a profit handed back the contract there would be no more services running. Pretty much every hospital is operating at a significant loss. Services can not survive if they only received the tariff. We talk all the time about an under funded NHS and this is one of the consequences. The difference is that if the private company says they don't want to run a service anymore then the NHS has to take it back on and carry that loss. The services that are being run well privately you don't even notice and they aren't coming back.
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I'm not saying private is bad but private = money to shareholders rather than staff.

'Pretty much every hospital is running at a loss'?
 
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