exiledinboro
Well-known member
So what are the Tories then? I genuinely have no idea
The closest I can pin them down to is a kleptocracy
The closest I can pin them down to is a kleptocracy
YouGov Poll - 33 Point lead!
- Thread starter Chris_Boro
- Start date
Laughing
Well-known member
Seems fair enough. They certainly don't uphold the traditional tory ideological tenets
Andy_W
Well-known member
Yeah, people don't like detail, they like snapshots aimed at not covering the point, but suiting a specific narrative and a target audience they can con.
I know most won't read all that, but at least try to back up what I'm saying and why, avoids me having to do 20 posts
Andy_W
Well-known member
You're welcome to disagree, but please explain why?
Labour last won under Blair, who most of the left of labour seem to dislike.
The centre controls who wins, whether you like that or not is irrelevant, it's a fact, a swing voter is worth the most by far, in an effective two-party FPTP system. It's crap, and not fair, but it doesn't mean it's not true, and unfortunately, policy has to chase these voters.
Changes can make things better, it's a fact, but sure they can also make things worse, it depends who is doing the changes, and why, but in either case, if there are constraints (which there are), then it generally means changes are necessary.
Did you work in NHS management? The NHS is one of the most under-managed organisations in the UK, the ratio of workers to managers is massive, which it shouldn't be. It's managers who control and allocate resources, so they can be used most effectively.
Three of my best friends work in A&E, my mums a lifelong nurse, step-mum works in the NHS et, I work on NHS maintenance/ construction contracts, but rarely as what I do is very niche/ specialist etc. Most I speak to say they're under-resourced, but extremely badly managed, not necessarily lower management, more so from above that and top levels.
Staffing is a big problem, as everyone knows, but 10,000 brand new nurses starting tomorrow wouldn't fix the majority of the problems, these problems are baked in from a decade ago, and they likely need to be fixed in an alternate way. Sure, adding more nurses at lower levels will help, and as they grow into older roles this will help the future, if they're retained and if there's good job progression into the management roles which the NHS needs. But that's not a problem solver for now, and it's not quick. It needs to retain experience, as much as it needs new staff, or to get more of it from somewhere (only option I see is from abroad, paying managers more to get them interested in moving from private practice, or paying people more to stay on in the NHS, rather than retiring at first opportunity). They need to be treat better either way, as treating them like crap, as we do now will continue to wreck everything.
I've posted threads by analysts (John Burn Murdoch put a really good one together on Twiter, which was very detailed) which explained what is largely causing the lack of available beds, and one of the main drivers is being able to get people out of the beds, who are fit enough to leave. The problem is they have nowhere to go. Adding more beds would work, but it's not fixing the problem of getting people out of the beds, which is sapping funds and resources. We need more beds as the population gets older, but they've been cut for the last 23 years (other than for covid). Sure, they had too many early 2000's, but Labour got waiting lists down and improved performance metrics even with 30% less beds. The Tories cut beds another 30% though, and never maintained the performance levels, this needs reversing. Then we will need gradually more beds per year, to factor for the older population share, which is going to increase fo the next 40 years or whatever.
We need to educate the public better, an example would be to stop people going to A&E because they can't get a doctor's appointment. People can't get a doctor's appointment as the doctors are over-subscribed and loads of the appointments are taken up by people who could be sorted at a pharmacy, or with a one-minute online consultation. Even if it's just a triage which diverts calls to the GP, the pharmacy, minor injuries unit, x-ray department, or pushed up the chain if more serious etc. The tech is there to direct people to where they need to go, a lot more efficiently.
Who said have private companies run or own more services? I never? Do you mean run or own? I was for nationalising the GP surgeries and integrating them better, rather than effectively being contractors. I also want to have social care integrated with the NHS, rather than ran by councils, and coming from council budgets etc.
I'm not against private aspects running certain sectors though (not owned though), if they can hit higher targets for the same or less cost, and be penalised if they don't. Effectively I want better/ more cost-effective care, everything can be more efficient.
ThePrisoner
Well-known member
kakocracy.
Edit..
I meant kakistocracy. It's a real word.
https://en.wikipedia.org/wiki/Kakistocracy
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asredastheycome
Well-known member
"People can't get a doctor's appointment as the doctors are over-subscribed " but surely the numbers have not massively increased since Covid. I know there are probably less doctors but even before Covid it was almost impossible to actually see a doctor. This is one of the things that need sorting. Get doctors sorted and it would bring down the numbers going to A&E.
Laughing
Well-known member
I have seen htis graph loads recently, it brings in to stark relief the reality of NHS funding under labour and tory governments.
there is a similar one with spending against gdp and it looks the same, cept of course, reversed.
Capybara
Well-known member
You see, instead of trying to look slightly less bad than the Tories, the Labour Party should be banging on about this. No amount of propaganda by the Tories and their press allies about Labour spending will gain traction when set against this simple, straightforward graphic.
exiledinboro
Well-known member
Labours record of the NHS compared to the Tories is something I think is absolutely clear and those graphs show it and I think we’ve all probably noticed
Andy, what service do you think should be run by private companies and I’ll explain my view in response
Cameron and the Andrew Lansley health act meant the NHS has to put its services up for tender where the NHS bids to retain the service compared to private companies that submit bids against it which are usually lower
So that’s been in place to just under 10 years
Which service providers Andy would you like to use as an example of where it works?
Andy, what service do you think should be run by private companies and I’ll explain my view in response
Cameron and the Andrew Lansley health act meant the NHS has to put its services up for tender where the NHS bids to retain the service compared to private companies that submit bids against it which are usually lower
So that’s been in place to just under 10 years
Which service providers Andy would you like to use as an example of where it works?
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Andy_W
Well-known member
The numbers have massively increased because of covid, it caused a massive backlog (which has effected beds, A&E, GP's, Physio's etc, it's all linked) and covid effectively becomes an amplifier for many other issues. The couple that with the issues covid has caused for staff, illnesses etc. The Tories have cocked up massively, up to Covid, but Covid came and bit them (and us) in the ****. It's not all their fault mind, it wouldn't have been easy for any healthcare system to deal with, which is why they're all struggling (to a lesser degree).
The population has only got gradually older in that time of course, but that's a long-term problem which adds up every day, just like the Tory problem adds up every day.
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Lefty
Well-known member
It should be on billboards all over the country.
I might add that those on the left undermining Starmer and complaining Starmer is too much like Blair and Tory lite should look at the graph as well and ask themselves which colour they prefer.
ThePrisoner
Well-known member
Tories continue to smash it out of the ground.
Sorry, I meant 'into the ground'.
Sorry, I meant 'into the ground'.
Andy_W
Well-known member
Pretty much any aspect could be run better, just like any area could do with more workers and a better (more standard) ratio of management to workers. It's not necessarily individual areas, it might be the whole thing, and it's all interlinked.
From my experience, private companies tend to run better than public ones as they have to, and tend to have the best people running them, as they pay more money for them. They need to be cost-effective and competitive or they go broke. Then couple that with poor performance leads to the sack or people being moved to less influential/ responsible areas, which happens a lot less in the public sector.
It was the same in the RAF, sure all of us on the ground did a good job, in tough conditions, but it was so badly run, extremely inefficient and extremely wasteful, which everyone could see and agreed on. Our lower management and mid management had their hands tied, loads of the problems were caused by poor regulation, for fear of regulation through lack of understanding, and top level management. The top level management never got to see how it actually was on the ground, as they were very rarely there, and when they were there our lower management was effectively told to lie, by the middle management, as the lower top management effectively told them they wanted lies, it was mental, it was a pure fugazi. It's even worse now apparently.
Same applies to now for my construction company, when we price work on council jobs. They're so badly ran it's beyond a joke, we have to double our price (or use rates on a job which should be fixed price) due to how many errors we know the client (council) will make, and how much extra time this will cause. We can't risk it running into other work (so price to assume it will take longer), and delaying the next job, and losing long term clients who do know how to plan/ price correctly.
Same applies on HS2, the company is effectively owned/operated by Network Rail/ the government/ people, the designs they have put forward are laughable. Projects which could be done for 50k are costing 250k as they're so badly/ inefficiently designed. It's not the designer's fault or the contractors, it's that the designers are being told to go way OTT by NR/ HS2/ policy/ regulation, and any time they cross NR, Highways or Council land, they have to fight their own NR/ Highways and Council regulation, who are meant to be on the same side. Never mind that of the regulation they put on the utility asset owners, which then comes to bite them back in the ****. It's like a massive feedback loop of inefficiency and increased costs. It's paying a lot of people to run around in circles mind, so I suppose it's good for employment if nothing else.
Like I say though, I definitely don't want the NHS privatised, I don't want it run for profit, but it needs to be looked at like a business, and how efficiency can be improved, what is causing backlogs etc. It needs to do better for the money spent, but this is 110% in no way the fault of those at the lower levels, those actually treating patients etc.
I'm not against tendering, if it's linked to targets and there are penalties, it works better than just having free reign to the chequebook. Competition should be a good thing if things are not corrupt, even if the tendering is only used as a feasibility/ confidence check on the cost. There has to be some accountability though, maybe big bonuses for those who control various sectors of the NHS, if they do a good job, on budget etc. I've no doubt some aspects could be tendered out for less cost, and hit better performance targets, but this could only be done if the client manages it correctly which effectively the Tories as a client of the NHS will not do. Labour could do better if they recruited the right people to run this (not a politician who has zero expertise on this), but it would cost a lot to get them, and press would have a field day with that. The later issue though is when Labour lose power it's back to the tories being the client again. It could still work, but there would need to be some extreme controls, which cannot be altered to suit people getting backhanders.
exiledinboro
Well-known member
Andy, keep it short you prefer private NHS service to public so which companies or service are you referring to?
exiledinboro
Well-known member
Sunak must be doomed
Teachers striking now
Teachers striking now
ThePrisoner
Well-known member
Write out one hundred lines...
You must provide a minimum service level or you will be sacked
You must provide a minimum service level or you will be sacked
You must provide a minimum service level or you will be sacked
You must provide a minimum service level or you will be sacked
You must provide a minimum service level or you will be sacked
You must provide a minimum service level or you will be sacked
festa5
Well-known member
Andy_W
Well-known member
Can't keep it short and be thorough, it's an extremely complex topic.Andy, keep it short you prefer private NHS service to public so which companies or service are you referring to?
When/ where did I ever say that I wanted a private NHS? Although saying that, I just want it ran the best way possible. It doesn't mean it couldn't be better than it is now, if they could hit better targets for less money (tendering) then it would make sense. Why wouldn't it? I wouldn't want it making obscene profits, but massive contracts like that are usually priced on 1-2% profit, or cost plus 1% etc. I'd rather have a company running it and hitting targets for less money, making 1% themselves, than spending more and not hitting targets.
Public-owned with heavy oversight by qualified people (not a politician), but privately ran or running it like a private company maybe, for some aspects, depends who the government is and who is running it. Absolutely must have minimum standards better than now, say to meet 2010 levels (which will also need a lot more funding and staff), and offer better value though, otherwise, it's pointless. Wouldn't trust the Tories to do it this way though, which is a problem when they're in power 2/3rds of the time. It would need to be locked out, so Tories could not funnel money into their mates (or own) private companies, and so we don't have companies/ people with zero skillset for what is required, like they did with PPE etc.
I don't think I've seen any good examples of something which is publicly owned and publicly ran, which is efficient and modernised, not in the UK anyway. It would be good if anyone had some good UK examples? I've got examples which are horrendous: rail, councils, construction (of public projects, private works fine/ very well), highways, utilities etc, and I expect the same continues with the NHS, seeing as anyone working in the NHS I speak to says it's so badly run.
Specific people or companies, for health? Which ones do you think work well, or are efficient? Which aspects have adequate management ratios and would hit budgets and performance targets, even if we did have more doctors and nurses? I've no idea, largely not my sector other than some utilities and construction on NHS sites, which they **** up as the client and as selecting or controlling main contractors. But the people will be out there, even if it meant recruiting from countries that were more efficient than us, which is not hard to find nowadays. Other countries just run public services better than we do, and that's not often due to more funding or people, whether that's health, energy, rail, highways etc. Hard to pinpoint that problem from our end/ level, so get someone top-level from places where their systems work.
Like I keep saying though, the NHS does need more funding and more nurses/ doctors etc, a lot more of both, everyone in the world knows this, but these are a million miles from being the only problems. Any company, service or workforce should embrace change if it could lead to better efficiency, and maybe even less cost, through modernisation. Every other industry can do it, if it has the right people running it, the right high and medium level management, right controls, right contracts etc.
exiledinboro
Well-known member
Andy, I asked which company as an example do you think offers a good service as a NHS service provider
And as I explained the reason is I will explain how it works from the inside.
So keep it short
We can also look at the companies satisfaction and quality rating
Btw you said pharmacists can take on primary care work. Did you bother to look if we have a pharmacist shortage?
And as I explained the reason is I will explain how it works from the inside.
So keep it short
We can also look at the companies satisfaction and quality rating
Btw you said pharmacists can take on primary care work. Did you bother to look if we have a pharmacist shortage?