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Who do they think they're fooling?


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1 hour ago, MennoR said:

 friend of mine is a self-employed financial controller for hospitals and medical care in general. His idea of cutting costs are pretty down-to-earth: "Top of the range operating theatres are idle during the evening, night and weekends. Doctors don't want to work those hours! Better use of that material (once bought) can cut costs!"

Menno

Been there, Menno, had that battle with the bean counters.   Trouble is, they can't see beyond their cody sheets.   Three times as many operating lists (three shifts per 24 hours) means three times as many beds - not all ops can be day cases, who need a bed for a while anyway.    And three times as many theatre staff and clinical staff. Three times more laundry, drugs, surgical supplies etc.etc.   Sure, the fixed costs of the facilities and kit stay the same, although you might need to replace them three tomes sooner, but the other costs multiply, and staffing is the greatest of these.

John

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18 hours ago, JohnD said:

When you consider the record of the Tories privatising - they call it "outsourcing" - other state services to Carillion, Interserve, G4S etc, keeping that sort of asset stripping out of the NHS seems like good sense.

Kind of makes my point for me John.  We were talking about funding models and you jump in with Carillion.  As it happens I don't have a dogmatic view on why the NHS should directly employ cleaners, buildings maintenance workers, security, carpark attendants etc.  It's also worth noting that a massive amount of 'privatisation' came in under Blair and Brown with the catastrophic PFI contracts.

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18 hours ago, JohnD said:

This chart may be of interest:

image.png.c4d081fb77d76ef6e9414af3300a73cc.png

We are at the bottom end of the middle group that Ireland leads, because the NHS has been starved of funds by a Tory led 'austerity' policy.   That policy was more an ideological vote winner than a measured, rational economic policy, and has long been overtaken by events.   The chanceller has more than enough spare cash to revive the NHS, but is keeping it in store as a protection against the awful impact of Brexit.

And this is the fundamental dilemma.  Is the NHS starved of cash or does it have an insatiable appetite.  I'm not a flag waver for the Tories but they are spending more on the NHS than has ever been spent before according to the graph below.

FINAL_govt_average_1979_onwards.PNG

The Government is currently spending 7% of GDP on the NHS.  What should it be, 10% 15%?

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And don't forget Blair and to a lesser extent Brown were riding a wave of world economic growth. I remember a political commentator saying that the Blair era would have had to really really cock things up (more than usual for politicians) if they hadn't delivered big spending plans. Blair ran away when he saw the good times coming to an end, and left Brown to look the bad guy. When he left, as that infamous note said, there is no more money. 

So who is to blame for austerity? the government who had massive incomes, and spent the lot, or the ones who came in and had nothing? 

Somewhere it all needs to be balanced. But politicians are notorious for giving away everything during the good times, and doing a Blair when it nosedives. And then the public blame the next government when the money available is reduced. And those cycles have little to do with the government of the day. Or indeed at all, but the world economy dictates it.

When Blair was selling off this countries assets wholesale (PFI, gold etc) and increasing NI it was easy to get people to swallow "tax" increases to "save the NHS" However, today, with an economy in the doldrums, lots of spending being held back etc, not to mention the "B" word people may not like the idea that the money has to come from somewhere.

But the NHS does also have an insatiable appetite. There always seems a list of things that they would like, medications, scanners etc and no doubt to remove some restrictions on treatment ages etc. So if you doubled spending, it would all be spent and still not enough. 

The other huge drain on the NHS is being dumped on for social care which is not its responsibility AFAIK. And that is a huge worry for the future. Most people are simply not paying enough into the pension pots to cover their retirements, state or otherwise. 

 

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Germany, Sweden and France spend 11% of GDP on healthcare.    7% is down with the poor European relations.

Anyone who thinks the NHS is profligate with money, or wasteful in any way should consult the Mirror, Mirror reports from the Commonwealth Fund.    That has found in repeated issues that the NHS over performs any other system on multiple factors.   See https://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirror-mirror-2017-international-comparison-reflects-flaws-and

John

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