Howdy, Stranger!

It looks like you're new here. If you want to get involved, click one of these buttons!

politicalbetting.com » Blog Archive » The Tories need to move the agenda off the NHS if they’re to h

SystemSystem Posts: 3,967
edited January 24 in General

imagepoliticalbetting.com » Blog Archive » The Tories need to move the agenda off the NHS if they’re to have any chance

I had sort of stopped watching PMQs every week because it is just less interesting and less important. Corbyn is getting a bit better but both he and TMay are pedestrian compared with others that we’ve seen over the years.

Read the full story here


«134

Comments

  • We need Dave back.

    He was bullet proof on the NHS.
  • Yes PMQs is tedious.

    We need a performer like this back.

  • FF43FF43 Posts: 5,892
    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?
  • tpfkartpfkar Posts: 831

    We need Dave back.

    He was bullet proof on the NHS.

    Surely Theresa should be as well? I think one of the most impressive things about her is her ability to function despite Type 1 diabetes. Thinking how well she did on the smear test question, a much more personal line on the NHS is surely open to her and would let millions see why she does care about the NHS.
  • tpfkar said:

    We need Dave back.

    He was bullet proof on the NHS.

    Surely Theresa should be as well? I think one of the most impressive things about her is her ability to function despite Type 1 diabetes. Thinking how well she did on the smear test question, a much more personal line on the NHS is surely open to her and would let millions see why she does care about the NHS.
    The damage is done with her.

    People have made up their minds on her, plus the party won’t let her fight another election.
  • MortimerMortimer Posts: 9,116
    tpfkar said:

    We need Dave back.

    He was bullet proof on the NHS.

    Surely Theresa should be as well? I think one of the most impressive things about her is her ability to function despite Type 1 diabetes. Thinking how well she did on the smear test question, a much more personal line on the NHS is surely open to her and would let millions see why she does care about the NHS.
    +1
  • MaxPBMaxPB Posts: 13,549
    It's her own stupid fault for not committing to he £350m per week for the 2017 campaign.
  • SandpitSandpit Posts: 16,117
    edited January 24
    Dave was very good at PMQs. But so was Hague, and look where that got him.

    I dislike John Bercow intensely but he’s completely right that the behaviour of MPs at this session looks terrible to the public.
  • MaxPBMaxPB Posts: 13,549
    Sandpit said:
    Dave won a majority against the odds. He's the best leader we've had since Mrs Thatcher.
  • Sandpit said:
    Dave won two general elections and two referendums.

    You can be good at winning and PMQs, it’s not an either or.
  • RobDRobD Posts: 31,300
    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    In your quote she didn't say it was booming, just that it would get worse under Labour.
  • old_labourold_labour Posts: 2,663
    The FT have taken down the paywall for the fundraiser story.

    https://www.ft.com/content/075d679e-0033-11e8-9650-9c0ad2d7c5b5
  • MaxPBMaxPB Posts: 13,549
    tpfkar said:

    We need Dave back.

    He was bullet proof on the NHS.

    Surely Theresa should be as well? I think one of the most impressive things about her is her ability to function despite Type 1 diabetes. Thinking how well she did on the smear test question, a much more personal line on the NHS is surely open to her and would let millions see why she does care about the NHS.
    The government campaigned on the back of a leave vote and winning over the 52%. One of the central claims of the leave campaign was £350m per week to the NHS. She decided in 2017 not to deliver that and until she does, or on some level delivers some kind of "Brexit dividend" to the NHS as the leave campaign said it would, then she will not be trusted on the NHS.

    She may not have made the £350m per week pledge, but becoming the defacto leader of leave in parliament means she will need to live up to the policy in some manner.
  • Morris_DancerMorris_Dancer Posts: 40,653
    Good afternoon, everyone.

    F1: I'd forgotten about this, but rumours of a Force India name change have been around for months. They might still do it, but testing's next month so they'll need to get their skates on.
  • stevefstevef Posts: 1,006
    RobD said:

    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    In your quote she didn't say it was booming, just that it would get worse under Labour.
    Labour said the same thing to Thatcher in the 80s. It didnt work.
  • Philip_ThompsonPhilip_Thompson Posts: 12,561
    If the Tory manifesto had been:

    350mn for NHS by 2022
    Abolish Triple Lock and means test WFA.
    A review into care funding

    Then the Tories would have likely won a very healthy improved majority.
  • dixiedeandixiedean Posts: 1,872
    PMQS has become almost unwatchable. Long, rambling questions, irrelevant nonanswers. It plays to neither leaders' strengths.
  • dixiedeandixiedean Posts: 1,872
    Chair of Women into Business, Tina Knight, giving one of the worst interviews ever on R5L re FT story.
  • AlastairMeeksAlastairMeeks Posts: 18,555
    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.
  • RobDRobD Posts: 31,300

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
  • SandpitSandpit Posts: 16,117
    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
  • david_herdsondavid_herdson Posts: 13,334
    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    It probably will get them. That doesn't negate her point about Labour and the economy.

    But Mike is right. This is an issue that the Tories need to make disappear. More money in the short term is probably essential. In the medium term (i.e. 3-5 years) the government needs to make an integration of social care and health treatment work. That probably means transferring responsibility from councils to the NHS.
  • RobDRobD Posts: 31,300
    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I’m sure the NHS has the ability to deny unnecessary treatments (well, most of the time)
  • Richard_NabaviRichard_Nabavi Posts: 17,646
    edited January 24
    The Tories, or indeed any responsible government, will always get beaten on the NHS in the sense that no matter how much money is spent, a huge monolithic nationalised health industry like the NHS will always need more money and can never satisfy 100% of demand, especially when demand rises relentlessly for demographic reasons. Therefore the Conservative strategy should be to try to neutralise the argument as much as possible, do as good a job on the NHS as possible, and be realistic about the fact that, even if it were all running smoothly, it would still require an increasing share of GDP just to keep up.

    At the same time, the Conservatives need to focus on the absurdities of Corbyn's fantasy economics. Any fool can pick a figure - £350m a week, for example - and say they'll increase NHS spending by that amount. If that were all Labour were saying, it might be hard to counter, but they are also saying they'll spend zillions more on all sorts of dumb things, such as £4.6bn on a purely ideological change to ownership of the Royal Mail, and miraculously add all this extra spending with no tax increases except on the super-rich. A well-crafted attack should concentrate on the line that they are just throwing off spending pledges at random, and they are not credible in aggregate.

    But Theresa May is the leader at the moment. We won't get well-crafted attacks. Yet.
  • volcanopetevolcanopete Posts: 1,851

    The FT have taken down the paywall for the fundraiser story.

    https://www.ft.com/content/075d679e-0033-11e8-9650-9c0ad2d7c5b5

    sounds a bit like some of the "Dustman Balls" of the 80s, a good place for under-graduates to get their graduation.The binmen of the day offered a very personal service.
  • FoxyFoxy Posts: 791
    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

  • TheWhiteRabbitTheWhiteRabbit Posts: 6,489
    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

    "The market introduces ‘transaction costs’ - advertising, negotiating, contracting, invoicing, billing, auditing, monitoring contracts, collecting information, resolving disputes both in courts and out, all employing and training a ballooning bureaucracy - even leaving aside any profits extracted by the private sector."

    How much of that would we really get rid of?

  • CharlesCharles Posts: 18,668
    edited January 24

    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    It probably will get them. That doesn't negate her point about Labour and the economy.

    But Mike is right. This is an issue that the Tories need to make disappear. More money in the short term is probably essential. In the medium term (i.e. 3-5 years) the government needs to make an integration of social care and health treatment work. That probably means transferring responsibility from councils to the NHS.
    If they were smarter you'd split the NHS into 3 separate organisations with separate boards, all reporting to the SoS.

    NHS Primary Care
    NHS Acute Care
    NHS Social Care

    The needs are very different, both from a patient perspective and a resourcing (capital and human) perspective.

    edit: and the services shouldn't necessarily be co-located. I'd look at splitting triage from the acute locations, for example.
  • IanB2IanB2 Posts: 9,543

    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    It probably will get them. That doesn't negate her point about Labour and the economy.

    But Mike is right. This is an issue that the Tories need to make disappear. More money in the short term is probably essential. In the medium term (i.e. 3-5 years) the government needs to make an integration of social care and health treatment work. That probably means transferring responsibility from councils to the NHS.
    Yet most local authorities deliver social care far more cost effectively than the NHS could or would. Therein lies the dilemma, since it is hardly practical to transfer much healthcare (beyond public health, which they already have) to local councils.
  • RobDRobD Posts: 31,300
    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

    twitter.com/foxinsoxuk/status/955926242481659904
    If it's being run as a market, does that help reduce costs for contracts etc.? Perhaps the increase in administration is made up for in savings that way. Interesting article though, thanks.
  • Richard_NabaviRichard_Nabavi Posts: 17,646
    Charles said:

    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    It probably will get them. That doesn't negate her point about Labour and the economy.

    But Mike is right. This is an issue that the Tories need to make disappear. More money in the short term is probably essential. In the medium term (i.e. 3-5 years) the government needs to make an integration of social care and health treatment work. That probably means transferring responsibility from councils to the NHS.
    If they were smarter you'd split the NHS into 3 separate organisations with separate boards, all reporting to the SoS.

    NHS Primary Care
    NHS Acute Care
    NHS Social Care

    The needs are very different, both from a patient perspective and a resourcing (capital and human) perspective.

    edit: and the services shouldn't necessarily be co-located. I'd look at splitting triage from the acute locations, for example.
    The key thing is to ensure that whichever body is responsible for ensuring that an elderly patient can be safely discharged from hospital holds the budget both for the hospital and for the cost of the social care outside hospital. Otherwise you have the present extremely unsatisfactory situation where the local council is very strongly incentivised not to make provision and to leave the patient in the hospital bed (because the cost of an alternative comes out of their budget, which they've already spent), even though that costs the taxpayer much more overall.
  • david_herdsondavid_herdson Posts: 13,334
    I've just been called a "pompous ass (not arse)" by Sir Michael White. Snigger.

  • MaxPB said:

    tpfkar said:



    The government campaigned on the back of a leave vote and winning over the 52%. One of the central claims of the leave campaign was £350m per week to the NHS. She decided in 2017 not to deliver that and until she does, or on some level delivers some kind of "Brexit dividend" to the NHS as the leave campaign said it would, then she will not be trusted on the NHS.

    She may not have made the £350m per week pledge, but becoming the defacto leader of leave in parliament means she will need to live up to the policy in some manner.

    Neither side in the referendum campaign had any right to make any spending promises whatsoever. The referendum was about whether or not we leave the EU and certainly not about trying to dictate domestic spending policies - the only aspect of the referendum that any government should feel bound by is the answer to the only question that was actually on the ballot paper.

    Luckily for you, your side won. Sadly for me, my side lost. That's all though.

  • Richard_NabaviRichard_Nabavi Posts: 17,646

    I've just been called a "pompous ass (not arse)" by Sir Michael White. Snigger.

    What had you said?
  • CyclefreeCyclefree Posts: 9,335

    Charles said:

    FF43 said:

    May can't say "Never mind about the NHS. Think what Labour would do with the economy.", which is her normal deflection. If the economy is booming so much under her skilful management why can't the NHS get needed funds?

    It probably will get them. That doesn't negate her point about Labour and the economy.

    But Mike is right. This is an issue that the Tories need to make disappear. More money in the short term is probably essential. In the medium term (i.e. 3-5 years) the government needs to make an integration of social care and health treatment work. That probably means transferring responsibility from councils to the NHS.
    If they were smarter you'd split the NHS into 3 separate organisations with separate boards, all reporting to the SoS.

    NHS Primary Care
    NHS Acute Care
    NHS Social Care

    The needs are very different, both from a patient perspective and a resourcing (capital and human) perspective.

    edit: and the services shouldn't necessarily be co-located. I'd look at splitting triage from the acute locations, for example.
    The key thing is to ensure that whichever body is responsible for ensuring that an elderly patient can be safely discharged from hospital holds the budget both for the hospital and for the cost of the social care outside hospital. Otherwise you have the present extremely unsatisfactory situation where the local council is very strongly incentivised not to make provision and to leave the patient in the hospital bed (because the cost of an alternative comes out of their budget, which they've already spent), even though that costs the taxpayer much more overall.
    Perhaps this is a silly question but why should social care be the responsibility of local councils at all?

    An organisation which deals with parking and bin collections does not seem to me to be the obvious organisation for looking after frail elderly people requiring personal social and medical care.

    Why shouldn't this be the responsibility of the NHS or a social care bit of it?
  • volcanopetevolcanopete Posts: 1,851
    OMG the sisterhood is out in full force.All a man can do is play for a rock and roll band,cross his legs and hide in the man-cave.
  • Morris_DancerMorris_Dancer Posts: 40,653
    Mr. Herdson, elsewhere in Twitterland, my heady mix of sartorial elegance and historical knowledge got the attention of Andrew Neil:
  • Richard_NabaviRichard_Nabavi Posts: 17,646
    Cyclefree said:

    Perhaps this is a silly question but why should social care be the responsibility of local councils at all?

    An organisation which deals with parking and bin collections does not seem to me to be the obvious organisation for looking after frail elderly people requiring personal social and medical care.

    Why shouldn't this be the responsibility of the NHS or a social care bit of it?

    It's not a silly question at all, it's a crucial question. I think the answer is probably that it shouldn't be. The fact that councils are involved is a historical accident going back to the fact that Victorian workhouses were the responsibility of local government.
  • RobDRobD Posts: 31,300

    Mr. Herdson, elsewhere in Twitterland, my heady mix of sartorial elegance and historical knowledge got the attention of Andrew Neil:

    Followers in common, or is he a fan of your work? :D
  • williamglennwilliamglenn Posts: 16,719
    Some questions to answer for the "I left early" club.
  • AlastairMeeksAlastairMeeks Posts: 18,555

    Mr. Herdson, elsewhere in Twitterland, my heady mix of sartorial elegance and historical knowledge got the attention of Andrew Neil:

    My all-time twitter highlight is being followed by Dean Friedman (I'd tweeted about LISAs).
  • TheJezziahTheJezziah Posts: 227

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    So you are saying the government will probably be able to keep it out of the news then.....
    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

    Wouldn't the NHS lose all the incredible advantages that come with privatisation then though?

    And what of the shareholders of companies that provide health products, what should they do with their investment. I understand one major shareholder in such a company is so poor he had to leave the country to reduce his tax bill... considering some of the dirt poor people I know who afford to pay their full tax bill I can't imagine what kind of poverty he may be forced into should his available money supply be made even smaller.
  • MarqueeMarkMarqueeMark Posts: 16,116

    Mr. Herdson, elsewhere in Twitterland, my heady mix of sartorial elegance and historical knowledge got the attention of Andrew Neil:

    I've often got the impression from the things he picks up on that Andrew Neil (or at least his researchers) keep close tabs on pb.com.....
  • david_herdsondavid_herdson Posts: 13,334

    I've just been called a "pompous ass (not arse)" by Sir Michael White. Snigger.

    What had you said?
    If you click on the tweet, it gives you the context. I did call him a dinosaur, to be fair. But then going by his comments, he is.
  • Morris_DancerMorris_Dancer Posts: 40,653
    Mr. Meeks, LISAs?

    Mr. D, I replied to a post of his about a warm period in Roman Britain.

    Mr. Mark, well he *is* a sensible fellow.

    As for highlights, I did like the response to my summary of the Lord of the Rings:


    Ahem, meant to be working. Will return to it now.
  • AlastairMeeksAlastairMeeks Posts: 18,555

    Mr. Meeks, LISAs?

    Mr. D, I replied to a post of his about a warm period in Roman Britain.

    Mr. Mark, well he *is* a sensible fellow.

    As for highlights, I did like the response to my summary of the Lord of the Rings:



    Ahem, meant to be working. Will return to it now.

    https://www.thesun.co.uk/money/3159105/lisa-lifetime-isa-providers-buy-house-retirement-martin-lewis/
  • FoxyFoxy Posts: 791

    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

    "The market introduces ‘transaction costs’ - advertising, negotiating, contracting, invoicing, billing, auditing, monitoring contracts, collecting information, resolving disputes both in courts and out, all employing and training a ballooning bureaucracy - even leaving aside any profits extracted by the private sector."

    How much of that would we really get rid of?

    About half of it, according to the analysis in the article, perhaps £10 billion annually.

    Does the internal market really save enough to cover that and more? I doubt it.

    An example: my department provides a specialist service hosted in larger GP practices, so as to provide specialist services closer to home. This is done at a much lower tariff than hospital outpatients, so a win all round. Then the CCG outsourced their properties to a property management company. This company then decided that we must pay room rent. We have no budget for this, and this arm of our service breaks even, with no surplus. Until the new financial year we will lose money on the service, though would make a good surplus if we sent the patients to our overloaded acute Trust outpatients. As such we have submitted for a substantial tariff uplift for next finyear.

    The end of this is that we bill the CCG more, so we can pay rent to them. This all creates work for penpushers and bean counters, and adds to churn without benefiting anyone, as we will wind up doing the same things to the same patients in the same places. That is what the internal market does, in a practical example.
  • CharlesCharles Posts: 18,668
    edited January 24
    Foxy said:



    About half of it, according to the analysis in the article, perhaps £10 billion annually.

    Does the internal market really save enough to cover that and more? I doubt it.

    An example: my department provides a specialist service hosted in larger GP practices, so as to provide specialist services closer to home. This is done at a much lower tariff than hospital outpatients, so a win all round. Then the CCG outsourced their properties to a property management company. This company then decided that we must pay room rent. We have no budget for this, and this arm of our service breaks even, with no surplus. Until the new financial year we will lose money on the service, though would make a good surplus if we sent the patients to our overloaded acute Trust outpatients. As such we have submitted for a substantial tariff uplift for next finyear.

    The end of this is that we bill the CCG more, so we can pay rent to them. This all creates work for penpushers and bean counters, and adds to churn without benefiting anyone, as we will wind up doing the same things to the same patients in the same places. That is what the internal market does, in a practical example.

    But it provides a mechanism to determine whether the space is being utilised most efficiently.

    Say someone wanted to come and rent that room for a sufficient price that you would be able to fund the work in the acute Trust outpatients plus the CCG would generate a surplus then that might be the most rational thing to do. But unless you had a price then you wouldn't necessarily know that

    (edit: and the article estimated the costs ranging between £4.5bn, £10bn and £20bn). So the saving could be a lot less than you are positing)
  • FoxyFoxy Posts: 791

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    So you are saying the government will probably be able to keep it out of the news then.....
    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

    Wouldn't the NHS lose all the incredible advantages that come with privatisation then though?

    And what of the shareholders of companies that provide health products, what should they do with their investment. I understand one major shareholder in such a company is so poor he had to leave the country to reduce his tax bill... considering some of the dirt poor people I know who afford to pay their full tax bill I can't imagine what kind of poverty he may be forced into should his available money supply be made even smaller.
    Do you mean this fellow, well known to PB?

  • TheJezziahTheJezziah Posts: 227
    No I did not, very interesting though.

    Was angling towards Branson, assuming he is a shareholder in Virgin, they have NHS contracts and he lives somewhere else for tax purposes.
  • Mr. Herdson, elsewhere in Twitterland, my heady mix of sartorial elegance and historical knowledge got the attention of Andrew Neil:

    I've often got the impression from the things he picks up on that Andrew Neil (or at least his researchers) keep close tabs on pb.com.....
    Or even post on here, from time to time, under a cunning disguise...
  • MaxPBMaxPB Posts: 13,549

    The Tories, or indeed any responsible government, will always get beaten on the NHS in the sense that no matter how much money is spent, a huge monolithic nationalised health industry like the NHS will always need more money and can never satisfy 100% of demand, especially when demand rises relentlessly for demographic reasons. Therefore the Conservative strategy should be to try to neutralise the argument as much as possible, do as good a job on the NHS as possible, and be realistic about the fact that, even if it were all running smoothly, it would still require an increasing share of GDP just to keep up.

    At the same time, the Conservatives need to focus on the absurdities of Corbyn's fantasy economics. Any fool can pick a figure - £350m a week, for example - and say they'll increase NHS spending by that amount. If that were all Labour were saying, it might be hard to counter, but they are also saying they'll spend zillions more on all sorts of dumb things, such as £4.6bn on a purely ideological change to ownership of the Royal Mail, and miraculously add all this extra spending with no tax increases except on the super-rich. A well-crafted attack should concentrate on the line that they are just throwing off spending pledges at random, and they are not credible in aggregate.

    But Theresa May is the leader at the moment. We won't get well-crafted attacks. Yet.

    I agree with you in principal, Richard. Throwing out random spending pledges is something the party can and should avoid. The problem in 2017 was that £350m per week wasn't a random figure and it had just played a big role in securing the largest ever democratic mandate this country has seen. A leave manifesto that didn't pledge to fulfil one of leave's main pledges was stupid, and not just in hindsight. Plenty of us in the party made our thoughts public at various meetings but the leader was completely shutting out any voices that weren't Nick Timothy or Fiona Hill.

    I didn't agree with the £350m for try NHS at the time Leave made the pledge, I don't think it is necessary now, however, we live in a world where a huge proportion of the 17m leave voters were motivated by that figure. No point in denying it. If the party had got behind that and given it credibility by making it the central pledge of the manifesto then we would be sitting on 350-360 seats, the 11 rebels would be of no consequence and the extreme Brexit lot could be safely ignored, and we'd save the £200m per year to the DUP.
  • The_TaxmanThe_Taxman Posts: 492
    PMQ's is definitely a big turn off these days. I don't watch it either as it has two adults bawling and shouting like children with a few hundred other MP's also harking back to pre- adolescent behaviour. It is embarrassing to watch!

    The PM is useless at PMQ's and the leader of the opposition is fairly poor in historical terms. Corbyn should be utterly smashing May week in and week out. He scores points but does not have the gravity or the panache to exploit PMQ's and build support in the country.

    The Tories are vulnerable on the NHS, however Corbyn just advises more money should be spent on it. I think what he needs to do in terms of drawing blood is identify where political decisions have been made and exploit them remorselessly. He needs May, Hunt and co. to take ownership of the problems the NHS are experiencing and pin the tail to the donkeys in charge. Sadly I don't think Corbyn is capable of this forensic examination.

    I maintain the view that we are being governed by a diminished political establishment who really should never have been put in positions of leadership. When I think of Theresa May as PM - I laugh, what a sack of rotten potatoes!
  • Morris_DancerMorris_Dancer Posts: 40,653
    Mr. Meeks, ah, I know of ISAs, of course but not the lifetime version.
  • williamglennwilliamglenn Posts: 16,719

    Mr. Herdson, elsewhere in Twitterland, my heady mix of sartorial elegance and historical knowledge got the attention of Andrew Neil:

    I've often got the impression from the things he picks up on that Andrew Neil (or at least his researchers) keep close tabs on pb.com.....
    Or even post on here, from time to time, under a cunning disguise...
    It can't be you. Neil is famously humourless.
  • FoxyFoxy Posts: 791
    Charles said:

    Foxy said:

    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?


    About half of it, according to the analysis in the article, perhaps £10 billion annually.

    Does the internal market really save enough to cover that and more? I doubt it.

    An example: my department provides a specialist service hosted in larger GP practices, so as to provide specialist services closer to home. This is done at a much lower tariff than hospital outpatients, so a win all round. Then the CCG outsourced their properties to a property management company. This company then decided that we must pay room rent. We have no budget for this, and this arm of our service breaks even, with no surplus. Until the new financial year we will lose money on the service, though would make a good surplus if we sent the patients to our overloaded acute Trust outpatients. As such we have submitted for a substantial tariff uplift for next finyear.

    The end of this is that we bill the CCG more, so we can pay rent to them. This all creates work for penpushers and bean counters, and adds to churn without benefiting anyone, as we will wind up doing the same things to the same patients in the same places. That is what the internal market does, in a practical example.
    But it provides a mechanism to determine whether the space is being utilised most efficiently.

    Say someone wanted to come and rent that room for a sufficient price that you would be able to fund the work in the acute Trust outpatients plus the CCG would generate a surplus then that might be the most rational thing to do. But unless you had a price then you wouldn't necessarily know that

    (edit: and the article estimated the costs ranging between £4.5bn, £10bn and £20bn). So the saving could be a lot less than you are positing)
    Our utilisation of these rooms has always been 100%, but if thems the rules, that is what we will do. We will add a percentage to cover our increased admin costs, as will the CCG.

    This is just a racket, as GPs are combined into megapractices, increasingly commercially oriented. The projection is that the UK's roughly 20 000 GP practices will be just 5 000 in another dacade, with the senior partners paid very well for managing multi-million pound businesses.
  • CharlesCharles Posts: 18,668
    edited January 24
    Foxy said:

    Charles said:

    Foxy said:



    About half of it, according to the analysis in the article, perhaps £10 billion annually.

    Does the internal market really save enough to cover that and more? I doubt it.

    An example: my department provides a specialist service hosted in larger GP practices, so as to provide specialist services closer to home. This is done at a much lower tariff than hospital outpatients, so a win all round. Then the CCG outsourced their properties to a property management company. This company then decided that we must pay room rent. We have no budget for this, and this arm of our service breaks even, with no surplus. Until the new financial year we will lose money on the service, though would make a good surplus if we sent the patients to our overloaded acute Trust outpatients. As such we have submitted for a substantial tariff uplift for next finyear.

    The end of this is that we bill the CCG more, so we can pay rent to them. This all creates work for penpushers and bean counters, and adds to churn without benefiting anyone, as we will wind up doing the same things to the same patients in the same places. That is what the internal market does, in a practical example.

    But it provides a mechanism to determine whether the space is being utilised most efficiently.

    Say someone wanted to come and rent that room for a sufficient price that you would be able to fund the work in the acute Trust outpatients plus the CCG would generate a surplus then that might be the most rational thing to do. But unless you had a price then you wouldn't necessarily know that

    (edit: and the article estimated the costs ranging between £4.5bn, £10bn and £20bn). So the saving could be a lot less than you are positing)
    Our utilisation of these rooms has always been 100%, but if thems the rules, that is what we will do. We will add a percentage to cover our increased admin costs, as will the CCG.

    This is just a racket, as GPs are combined into megapractices, increasingly commercially oriented. The projection is that the UK's roughly 20 000 GP practices will be just 5 000 in another dacade, with the senior partners paid very well for managing multi-million pound businesses.
    It's not about utilisation rates, though, it's about using the space in the best possible way.

    It may be that co-location is the right answer; but if someone is prepared to pay sufficiently more then that needs to be considered. Price is just a mechanism for people to think about value.
  • Richard_NabaviRichard_Nabavi Posts: 17,646
    Foxy said:

    Foxy said:

    Sandpit said:

    RobD said:

    Bit of a problem then. The NHS is heading for a demographic crisis that cannot indefinitely be staved off simply by throwing more money at it. The government will only be able to keep it out of the news if it has an even greater catastrophe coming down the tracks.

    Depends on how much money you throw at it. Unless money simply can’t fix it?
    What’s the demand for something free?
    I am not going to have a hip replacement just because it is free, if I don't need it!

    There are ways to cut costs within the NHS, to free up billions of pounds, without putting up taxes or borrowing:

    "The market introduces ‘transaction costs’ - advertising, negotiating, contracting, invoicing, billing, auditing, monitoring contracts, collecting information, resolving disputes both in courts and out, all employing and training a ballooning bureaucracy - even leaving aside any profits extracted by the private sector."

    How much of that would we really get rid of?

    About half of it, according to the analysis in the article, perhaps £10 billion annually.

    Does the internal market really save enough to cover that and more? I doubt it.

    An example: my department provides a specialist service hosted in larger GP practices, so as to provide specialist services closer to home. This is done at a much lower tariff than hospital outpatients, so a win all round. Then the CCG outsourced their properties to a property management company. This company then decided that we must pay room rent. We have no budget for this, and this arm of our service breaks even, with no surplus. Until the new financial year we will lose money on the service, though would make a good surplus if we sent the patients to our overloaded acute Trust outpatients. As such we have submitted for a substantial tariff uplift for next finyear.

    The end of this is that we bill the CCG more, so we can pay rent to them. This all creates work for penpushers and bean counters, and adds to churn without benefiting anyone, as we will wind up doing the same things to the same patients in the same places. That is what the internal market does, in a practical example.
    Oh dear me. I can't believe what I'm reading. The NHS shouldn't worry about property costs? Really?
  • stevefstevef Posts: 1,006
    The NHS will always fail to be an issue which fails to decide general elections.

    The Tories claim rightly that they are increasing NHS funding to its highest ever level, but fail to point out that increases in spending are not keeping up with inflation in healthcare, nor with demand caused by an aging population and new technology. The Tories at heart would prefer private health insurance to replace the NHS.

    Labour equally have problems. It is not enough for Labour to claim -wrongly -that the Tories cut the NHS. They dont.Labour is ideologically wed to the Bevanite 1948 NHS even though it was never designed to cope with modern costs and demand. Corbyn bangs on about not enough funding, but fails to explain where he would find sufficient funding other than to spend over and over again the extra taxes on the rich which he has already spent on abolishing student tuition fees, and higher public sector pay. Crucially he has said that no one except the rich will pay higher taxes -and therefore he too will not have enough money to properly fund the NHS.

    Time for both parties to be honest and think radically. Yes the NHS needs to be (mostly free at the point of use. American style private insurance is unacceptable. But people need to pay higher taxes to fund it Everyone needs to pay higher taxes. The NHS creaks on while Sweden and France are recognised as having much better systems.
  • Tissue_PriceTissue_Price Posts: 7,234

    We need Dave back.

    He was bullet proof on the NHS.

    Ask and you shall receive.
  • MarqueeMarkMarqueeMark Posts: 16,116

    I've just been called a "pompous ass (not arse)" by Sir Michael White. Snigger.

    What had you said?
    If you click on the tweet, it gives you the context. I did call him a dinosaur, to be fair. But then going by his comments, he is.
    Bit thin-skinned for a dinosaur, isn't he?
  • RobDRobD Posts: 31,300
    Why were the advisers in a secure bunker?
  • MaxPBMaxPB Posts: 13,549
    RobD said:

    Why were the advisers in a secure bunker?
    Does Theresa ever leave the bunker?
  • RobDRobD Posts: 31,300
    MaxPB said:

    RobD said:

    Why were the advisers in a secure bunker?
    Does Theresa ever leave the bunker?
    I got the impression she was in her office and they were listening in from the bunker? Maybe I'm misreading it.
  • TheWhiteRabbitTheWhiteRabbit Posts: 6,489
    RobD said:

    MaxPB said:

    RobD said:

    Why were the advisers in a secure bunker?
    Does Theresa ever leave the bunker?
    I got the impression she was in her office and they were listening in from the bunker? Maybe I'm misreading it.
    I suspect they are all in the bunker Rob!!
  • RobD said:

    Why were the advisers in a secure bunker?
    The secure communications room is in the Downing Street bunker.

    I’m assuming Mrs May made/received the call there.
  • The_TaxmanThe_Taxman Posts: 492
    stevef said:

    The NHS will always fail to be an issue which fails to decide general elections.

    The Tories at heart would prefer private health insurance to replace the NHS.

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy.

    The Tories will be shown the door if they go down the route of private health care. Toxic!
  • RobDRobD Posts: 31,300

    RobD said:

    twitter.com/mradamtaylor/status/956161185522515968

    Why were the advisers in a secure bunker?
    The secure communications room is in the Downing Street bunker.

    I’m assuming Mrs May made/received the call there.
    How could I have missed that after all my reprogramming sessions?
  • williamglennwilliamglenn Posts: 16,719
    RobD said:

    MaxPB said:

    RobD said:

    Why were the advisers in a secure bunker?
    Does Theresa ever leave the bunker?
    I got the impression she was in her office and they were listening in from the bunker? Maybe I'm misreading it.
    Presumably the practice dates from Gordon Brown and the need to protect them from flying Nokias.
  • RobDRobD Posts: 31,300

    RobD said:

    MaxPB said:

    RobD said:

    Why were the advisers in a secure bunker?
    Does Theresa ever leave the bunker?
    I got the impression she was in her office and they were listening in from the bunker? Maybe I'm misreading it.
    Presumably the practice dates from Gordon Brown and the need to protect them from flying Nokias.
    LOL (quite literally, at my desk)
  • HYUFDHYUFD Posts: 38,256
    Neil Kinnock thought he would win on the NHS in 1992 and spending more on it just like Corbyn until the Tories ran the 'Labour's tax bombshell' posters pointing out that it would be middle income earners who would have to pay for it through increased taxes
  • HYUFDHYUFD Posts: 38,256
    edited January 24
    stevef said:

    The NHS will always fail to be an issue which fails to decide general elections.

    The Tories claim rightly that they are increasing NHS funding to its highest ever level, but fail to point out that increases in spending are not keeping up with inflation in healthcare, nor with demand caused by an aging population and new technology. The Tories at heart would prefer private health insurance to replace the NHS.

    Labour equally have problems. It is not enough for Labour to claim -wrongly -that the Tories cut the NHS. They dont.Labour is ideologically wed to the Bevanite 1948 NHS even though it was never designed to cope with modern costs and demand. Corbyn bangs on about not enough funding, but fails to explain where he would find sufficient funding other than to spend over and over again the extra taxes on the rich which he has already spent on abolishing student tuition fees, and higher public sector pay. Crucially he has said that no one except the rich will pay higher taxes -and therefore he too will not have enough money to properly fund the NHS.

    Time for both parties to be honest and think radically. Yes the NHS needs to be (mostly free at the point of use. American style private insurance is unacceptable. But people need to pay higher taxes to fund it Everyone needs to pay higher taxes. The NHS creaks on while Sweden and France are recognised as having much better systems.

    France and indeed most developed countries pay for state healthcare largely through social insurance
  • Richard_NabaviRichard_Nabavi Posts: 17,646
    edited January 24

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
  • IanB2IanB2 Posts: 9,543

    stevef said:

    The NHS will always fail to be an issue which fails to decide general elections.

    The Tories at heart would prefer private health insurance to replace the NHS.

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy.

    The Tories will be shown the door if they go down the route of private health care. Toxic!
    The inflated cost and adverse social consequences of the American system are evidence enough. It is a remarkable statistic that the US spends a greater proportion of its GDP as government-funded healthcare for their free provision for veterans and Medicaid/care, than we do to finance the NHS for everyone.
  • HYUFDHYUFD Posts: 38,256

    Sandpit said:
    Dave won two general elections and two referendums.

    You can be good at winning and PMQs, it’s not an either or.
    So if Dave won the 2010 general election are you also saying May won the 2015 general election as well?
  • Philip_ThompsonPhilip_Thompson Posts: 12,561
    HYUFD said:

    Sandpit said:
    Dave won two general elections and two referendums.

    You can be good at winning and PMQs, it’s not an either or.
    So if Dave won the 2010 general election are you also saying May won the 2015 general election as well?
    No. She did however win the 2017 one, however since that wasn't a scheduled one like 10 and 15 but instead a premature one she called to increase her majority she failed in her objective.
  • The_TaxmanThe_Taxman Posts: 492

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
  • Richard_TyndallRichard_Tyndall Posts: 13,993

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Unfortunately Taxman seems to he one if those for whom the NHS is a religion whose tenets must never be challenged irrespective of the facts.
  • The_TaxmanThe_Taxman Posts: 492
    HYUFD said:

    Neil Kinnock thought he would win on the NHS in 1992 and spending more on it just like Corbyn until the Tories ran the 'Labour's tax bombshell' posters pointing out that it would be middle income earners who would have to pay for it through increased taxes

    Kinnock would have had to gain about 100 seats for an overall majority in 1992, that would be a tall order given the Tories were level pegging until the election was called.

  • CharlesCharles Posts: 18,668

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
    By delivering better outcomes for the same amount of money.

    Involving the private sector does not mean that the government is not an important stakeholder.

    Government financing (free at the point of need) is not the same as government provision (employing every doctor and nurse)
  • HYUFDHYUFD Posts: 38,256
    edited January 24

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
    Social insurance is used to pay for it in large part and not just taxes and deducted from wages. Australia requires the richest 10% or so to take out private insurance even if the state pays for the rest otherwise a levy is imposed on them
  • HYUFDHYUFD Posts: 38,256

    HYUFD said:

    Sandpit said:
    Dave won two general elections and two referendums.

    You can be good at winning and PMQs, it’s not an either or.
    So if Dave won the 2010 general election are you also saying May won the 2015 general election as well?
    No. She did however win the 2017 one, however since that wasn't a scheduled one like 10 and 15 but instead a premature one she called to increase her majority she failed in her objective.
    Sorry, meant the 2017 general election which like 2010 produced a hung parliament
  • The_TaxmanThe_Taxman Posts: 492

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Unfortunately Taxman seems to he one if those for whom the NHS is a religion whose tenets must never be challenged irrespective of the facts.
    No, unlike Tories like you I do use the health service and am aware that some people do not have the resources to buy their own health care. I cannot see how profit making companies can provide health care cheaper.
  • HYUFDHYUFD Posts: 38,256

    HYUFD said:

    Neil Kinnock thought he would win on the NHS in 1992 and spending more on it just like Corbyn until the Tories ran the 'Labour's tax bombshell' posters pointing out that it would be middle income earners who would have to pay for it through increased taxes

    Kinnock would have had to gain about 100 seats for an overall majority in 1992, that would be a tall order given the Tories were level pegging until the election was called.

    Kinnock also had a far more sizeable third party vote to squeeze, the SDP/Alliance got 22% in 1987 and the LDs just 7% in 2017
  • Richard_NabaviRichard_Nabavi Posts: 17,646
    edited January 24

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
    You are confusing who pays for the healthcare with who provides it. For some reason, presumably ideological blindness, this trivially simple distinction doesn't seem to be understood by lots of people. When you go to your GP practice (a privately-owned for-profit business), do you have to fork out?

    As for "I cannot see how profit making companies can offer health care cheaper than the NHS", presumably you must think the same applies to airlines, supermarkets, computer suppliers, car manufacturers, lawyers, and every other supplier of any goods or services. Or perhaps not - the reason why profit making companies are more efficient than nationalised industries is not a mystery, it's completely understood: they have a direct incentive to be so.

    And you ignored my point about other countries.
  • The_TaxmanThe_Taxman Posts: 492
    Charles said:

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
    By delivering better outcomes for the same amount of money.

    Involving the private sector does not mean that the government is not an important stakeholder.

    Government financing (free at the point of need) is not the same as government provision (employing every doctor and nurse)
    Good luck to the Tories trying to deliver that to voters. I will not vote for them again and would advise any other previous conservative voter to avoid them like the plague should they go down that road.
  • CookieCookie Posts: 814
    edited January 24
    I'm comfortably right of centre, but in general I like the NHS: I like living in a country where one needn't worry about how to afford to be ill. I don't really care how this is acheived, whether it be through a state behemoth, localised care, some sort of insurance, or other models, but I like health being free at the point of use (though really, it's not: we pay for things like prescriptions, dentistry, etc - and in all honesty I wouldn't mind a token charge to see a doctor as it might weed out a little bit of taking-the-piss). I wouldn't say it's perfect - the standard of healthcare in the NHS is generally good, though I don't know how it compares to other systems; the standard of customer service in the NHS is pretty variable. But in general I'm supportive of state spending on health. However, in a hypothetical world where we had, say, an extra £350m a week to spend - should health really be our priority? When we are starting our 21-year-olds out in life tens of thousands of pounds in debt and unable to contemplate ever affording to buy a house, should we really be spending our hypothetical windfall on the old and super-old?
  • I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Unfortunately Taxman seems to he one if those for whom the NHS is a religion whose tenets must never be challenged irrespective of the facts.
    No, unlike Tories like you I do use the health service and am aware that some people do not have the resources to buy their own health care. I cannot see how profit making companies can provide health care cheaper.
    Competition in services makes things cheaper and provides innovation.

    Public bodies require Companies to be successful to generate employment and profits with which the public sector derives it's income. Demonising the private sector will only result in a diminished public sector
  • The_TaxmanThe_Taxman Posts: 492

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
    You are confusing who pays for the healthcare with who provides it. For some reason, presumably ideological blindness, this trivially simple distinction doesn't seem to be understood by lots of people. When you go to your GP practice (a privately-owned for-profit business), do you have to fork out?

    As for "I cannot see how profit making companies can offer health care cheaper than the NHS", presumably you must think the same applies to airlines, supermarkets, computer suppliers, car manufacturers, lawyers, and every other supplier of any goods or services. Or perhaps not - the reason why profit making companies are more efficient than nationalised industries is not a mystery, it's completely understood: they have a direct incentive to be so.

    And you ignored my point about other countries.
    Sorry, I don't agree with you and I am a former Tory voter. I would now describe myself as a floating voter and if the Conservatives go down that road I could not support it.
  • Richard_TyndallRichard_Tyndall Posts: 13,993

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Unfortunately Taxman seems to he one if those for whom the NHS is a religion whose tenets must never be challenged irrespective of the facts.
    No, unlike Tories like you I do use the health service and am aware that some people do not have the resources to buy their own health care. I cannot see how profit making companies can provide health care cheaper.
    Well first I am not a Tory. Second I always use the NHS. Third you are showing a profound and I suspect wilful ignorance of the health systems of other countries to the extent that you are almost incapable of making any rational judgement

    Try actually learning something about the subject before commenting on it and you would save everyone a lot of time.
  • Charles said:

    I will not vote Tory again if they are going to dismantle the NHS, too many people would be adversely affected and public health would seriously deteriorate as would life expectancy...

    France, Italy, Spain, Sweden, Austria, Ireland, Luxembourg, the Netherlands, Norway and Portugal all have life expectancies as good as or better than ours, yet have largely or partly privatised healthcare provision, so I'd be interested to see your justification for that bald statement.
    Where do low income people get the money from to pay for their health care if the NHS ceases to provide care? I cannot see how profit making companies can offer health care cheaper than the NHS. Therefore a decline in public health will occur. No money = No health care.
    By delivering better outcomes for the same amount of money.

    Involving the private sector does not mean that the government is not an important stakeholder.

    Government financing (free at the point of need) is not the same as government provision (employing every doctor and nurse)
    Good luck to the Tories trying to deliver that to voters. I will not vote for them again and would advise any other previous conservative voter to avoid them like the plague should they go down that road.
    With respect that is fairly obvious but more will than for Corbyn by some distance
  • Richard_NabaviRichard_Nabavi Posts: 17,646

    Competition in services makes things cheaper and provides innovation.

    Tragically for the country, the LibDem U-turn on the Lansley reforms (having initially supported them) means that we haven't got proper price competition amongst NHS providers. At some point this will have to be revisited if we're ever going to get a better health service for the finite amount of resource available.
  • rcs1000rcs1000 Posts: 20,908
    Charles said:

    Foxy said:

    Charles said:

    Foxy said:



    About half of it, according to the analysis in the article, perhaps £10 billion annually.

    Does the internal market really save enough to cover that and more? I doubt it.

    An example: my department provides a specialist service hosted in larger GP practices, so as to provide specialist services closer to home. This is done at a much lower tariff than hospital outpatients, so a win all round. Then the CCG outsourced their properties to a property management company. This company then decided that we must pay room rent. We have no budget for this, and this arm of our service breaks even, with no surplus. Until the new financial year we will lose money on the service, though would make a good surplus if we sent the patients to our overloaded acute Trust outpatients. As such we have submitted for a substantial tariff uplift for next finyear.

    The end of this is that we bill the CCG more, so we can pay rent to them. This all creates work for penpushers and bean counters, and adds to churn without benefiting anyone, as we will wind up doing the same things to the same patients in the same places. That is what the internal market does, in a practical example.

    But it provides a mechanism to determine whether the space is being utilised most efficiently.

    Say someone wanted to come and rent that room for a sufficient price that you would be able to fund the work in the acute Trust outpatients plus the CCG would generate a surplus then that might be the most rational thing to do. But unless you had a price then you wouldn't necessarily know that

    (edit: and the article estimated the costs ranging between £4.5bn, £10bn and £20bn). So the saving could be a lot less than you are positing)
    Our utilisation of these rooms has always been 100%, but if thems the rules, that is what we will do. We will add a percentage to cover our increased admin costs, as will the CCG.

    This is just a racket, as GPs are combined into megapractices, increasingly commercially oriented. The projection is that the UK's roughly 20 000 GP practices will be just 5 000 in another dacade, with the senior partners paid very well for managing multi-million pound businesses.
    It's not about utilisation rates, though, it's about using the space in the best possible way.

    It may be that co-location is the right answer; but if someone is prepared to pay sufficiently more then that needs to be considered. Price is just a mechanism for people to think about value.
    Economics is the study of the efficient allocation of scarce resources.
    The "price" in a free market, is a piece of information that helps with that allocation process.
  • TOPPINGTOPPING Posts: 11,975
    I see that the Presidents' Club has been wound up so that's the last time 50-odd charities get to share £1.5m between them.
  • MarqueeMarkMarqueeMark Posts: 16,116
    Cookie said:

    I'm comfortably right of centre, but in general I like the NHS: I like living in a country where one needn't worry about how to afford to be ill. I don't really care how this is acheived, whether it be through a state behemoth, localised care, some sort of insurance, or other models, but I like health being free at the point of use (though really, it's not: we pay for things like prescriptions, dentistry, etc - and in all honesty I wouldn't mind a token charge to see a doctor as it might weed out a little bit of taking-the-piss). I wouldn't say it's perfect - the standard of healthcare in the NHS is generally good, though I don't know how it compares to other systems; the standard of customer service in the NHS is pretty variable. But in general I'm supportive of state spending on health. However, in a hypothetical world where we had, say, an extra £350m a week to spend - should health really be our priority? When we are starting our 21-year-olds out in life tens of thousands of pounds in debt and unable to contemplate ever affording to buy a house, should we really be spending our hypothetical windfall on the old and super-old?

    It's a very fair question, that never gets asked by our politicians.

    Personally, I would attract many more of the super-rich to the UK, and have the (fair) taxes they then pay used to give us a world-beating NHS. Unfortunately, we have an Oppositon party that seems hell-bent on getting rid of the wealthy we already have. Love 'em or hate 'em, these are the people that fund our NHS right now. The top 1% pay 27% of all Income Tax. Their loss to the Exchequer under Corbyn would be cataclysmic for the provision of health care. Either that, or Joe and Julie Avergae are going to get stung for thousands more in tax. Guess which.....
This discussion has been closed.