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Boromart Posted on 24/02/2011 18:26
Save the NHS

If you want to take action against the terrible NHS reforms you can.

Click on this website. Add your name, postcode and email address and an email will be generated to your MP to register your objection to plans that are aimed to be the start of the end for the NHS.

Then stick the link on your favourite social networking site so your friends can do it.

Link: Save our NHS

r00fie Posted on 24/02/2011 18:32
Save the NHS


enigma17 Posted on 24/02/2011 19:01
Save the NHS


blindschool Posted on 24/02/2011 20:10
Save the NHS

Come on Stockton South, only 7 so far - and we have a Tory MP.

susy Posted on 25/02/2011 19:48
Save the NHS


ron_manager Posted on 25/02/2011 19:51
Save the NHS


r00fie Posted on 25/02/2011 19:52
Save the NHS

50,000 potential jobs to go. Its already started with a jobs freeze across certain trusts.........

HarryVegas Posted on 25/02/2011 19:53
Save the NHS

Done [^]

Grumpy_Paul Posted on 25/02/2011 20:19
Save the NHS


BoroAl Posted on 25/02/2011 21:23
Save the NHS


Pogatetz_Ate_My_Hamster_ Posted on 25/02/2011 22:03
Save the NHS


It's for the best

Only_Me Posted on 25/02/2011 22:09
Save the NHS

I've been telling you lot for ages the NHS is doomed, it's an EU diktat, it has to go. That's why the post office is in the same boat.
If you really want to help the NHS start shouting about leaving the EU.

As things stand, I'd like to see the unnecessary managers go and more common sense used as far as procurement is concerned.
I'd also like to see PCT's being banned from using money which should be used on patient care to fund campaigns like the recent one concerning minimum alcohol pricing - tens of thousands of £'s spent that could have paid for more nurses.
Beyond that, it's one of the few jewels in the crown that we still have and the basic premise must be protected.

blindschool Posted on 25/02/2011 22:16
Save the NHS

Why would the EU want to get rid of the NHS. Britain has probably the worst health system in (original) europe.

Corcaigh_the_Cat Posted on 25/02/2011 22:20
Save the NHS

A wonderful institution from the days when we really cared about democracy and the development of the nation as a whole.

The extreme right have always despised it, now that they've got more control they could get their wishes granted.

Congratulations to all who voted for them.

Only_Me Posted on 25/02/2011 22:22
Save the NHS

It's all to do with 'nationalised ' industries/structures - we aren't allowed to have any! The Royal Mail and the NHS are just about the last 2 that we have standing, all the rest have already gone - gas, telecoms, leccy, the railways, etc., - all gone!

Only_Me Posted on 25/02/2011 22:24
Save the NHS

" The extreme right have always despised it, now that they've got more control they could get their wishes granted.

Congratulations to all who voted for them."

New Labour as just as responsible, they have signed us up to every treaty that the EU have sent our way, without question or hesitation.

whale_oil_beef_hooked Posted on 25/02/2011 22:24
Save the NHS

[^] done and posted on other sites.

Boromart Posted on 25/02/2011 22:48
Save the NHS

nice one, and lets keep this hoofed for all the other fmttmers with a moral compass

Pogatetz_Ate_My_Hamster_ Posted on 25/02/2011 22:57
Save the NHS

Too many fat-cats and middle managers lining their pockets.

Stop treating anyone who just turns up in this country, the NHS is for the people of this country and those that pay into it

GGGG Posted on 25/02/2011 22:59
Save the NHS

"Britain has probably the worst health system in (original) europe."


mooghead Posted on 25/02/2011 23:00
Save the NHS

This 'petition' will make so much difference I have voted a million times

[:o)] x you lot

Boromart Posted on 26/02/2011 11:01
Save the NHS

"Too many fat-cats and middle managers lining their pockets."
You have been listening to Tory propaganda. This isn't about efficiency it is about removing a public health service.

Yes some efficiency may be needed, but middle management is necessary. The job of middle management is to ensure we have enough resources, the right type of resource, the right capabilities, and to effect those resources and capabilities into service in line with strategy and budget. Middle management get a bad name by people who have no idea about enterprise architecture.

The alternative, a private sector health service will not remove the 'fat cats' from the health system, but will only make them richer at our expense. I suggest you think statements through to its conclusion before commenting.

Keep the vote going everyone, the population did not give the Tories a mandate to destroy OUR NHS.

HarryVegas Posted on 26/02/2011 11:26
Save the NHS

Boromart spot on [^]

myboro Posted on 26/02/2011 12:00
Save the NHS

Done - come on people get signed up

Forzagazza Posted on 26/02/2011 12:13
Save the NHS


Why would the Tory extremists want to keep an NHS when they are funded through Lord Ashcroft who was channelling money from American private health care companies who are only too happy to see a working social health care system destroyed and to pocket the money from GP fundholders

Boromart Posted on 26/02/2011 14:48
Save the NHS

Forzagazza , yes there are dark forces at work. There are plenty of US health care and insurance companies ready to jump in and control the UK market.

br14 Posted on 26/02/2011 14:54
Save the NHS

Perish the thought Britain ends up with a health care system as crap as the one in the Netherlands. They're another set of right wing extremists with private delivery of health care services. Bloody Dutch fascists.

Corcaigh_the_Cat Posted on 26/02/2011 14:58
Save the NHS

We haven't the social conscience of the Netherlands. We'd go the American way. Of that I have little doubt.

deganya Posted on 26/02/2011 15:04
Save the NHS

Interesting you should say that because I used to work in Holland many years ago and the system they had was a mixture of private health, private hospitals funded by 'sicken funds' which is I understand is a type of National Insurance specifically for health care including dentists. So in effect it was still free at the point of delivery. Now I hear lots of complaints about the system. I know Cameron is very keen on the UK going down a similar route, but that just means private health care providers getting their hands on £80 billion of public money. Our NHS has its faults but I can honestly say it is one of the best in the world, but still room for improvement.

br14 Posted on 26/02/2011 15:07
Save the NHS

CTC just read this board.

The fact is that anyone of any party who messes dramatically with the NHS will be out of power for a very very long time.

And while you may not like the US system, it's the best in the world for those that can afford it.

I live in Canada. My son recently needed an MRI scan. In Canada the wait time was about 13 weeks. I believe the UK is 6-10 weeks.

He went to Buffalo, New York and was seen the next day for $500. The Canadian consultant recommended he do so!

But you needn't worry about the US system arriving in the UK. Britain couldn't afford it. The US pays more per capita for health care than anyone else.

Not saying these reforms are necessarily positive. Just to reject them for ideological reasons is as daft as implementing them for ideological reasons.

The government is trying to save money. And it's the NHS non-health middle management that will suffer. Not health care provision.

Looks as though Labour tried attacking the admin costs but didn't succeed against entrenched management empire building.

br14 Posted on 26/02/2011 15:15
Save the NHS

The Netherlands came first overall in a 2010 study including Britain, Canada, Germany, Netherlands, Australia and New Zealand.

Britain actually came first in the quality of health care provided. It's the stuff around the health care that is the problem. Not as equal and not as efficient as elsewhere according to the report.

Corcaigh_the_Cat Posted on 26/02/2011 15:22
Save the NHS

The NHS is a good system. If you're wealthy enough you can jump the queue in the UK, you don't have to wait, not everyone has that choice.

You're right about the system down here, it's good if you're rich enough to use it. There was an advertisement on radio not so long ago that one of the communities had hired a hall and volunteers were flying in to give free treatment. That's the best system in the world for you.

deganya Posted on 26/02/2011 17:44
Save the NHS

The most criminal thing is they don't have a mandate to carry out these so called 'reforms', how do we stop them? We can't rely on the Lib Dems to suddenly grow a spine can we?

Boromart Posted on 28/02/2011 09:58
Save the NHS

keep this hoofed for anyone who hasn't seen it and wants to sign the petition

Razmond_HWDR Posted on 28/02/2011 10:01
Save the NHS

i am more concerned about other areas of reform.

NHS has been a mess for years no thanks to labour.... car parking, phoning home, wanna watch tv... it all costs crazy money now.

ABCD Posted on 28/02/2011 10:09
Save the NHS

50,000 job losses in the NHS is nothing. From what i ubderstand they turn over 7% every year anyway and employ over 1.5mill people.

So 50,000 pen pushers and failed IT staf lose a job. Do i care? NO.

Boromart Posted on 28/02/2011 10:12
Save the NHS

"car parking, phoning home, wanna watch tv... it all costs crazy money now." - 2 of those are so unimportant that it's not worth discussing. Parking costs are a joke though, if that is the worst thing about the NHS then it's been doing well.

Bernie_is_banned Posted on 28/02/2011 10:12
Save the NHS

ABCD - Spot on [^]

Razmond_HWDR Posted on 28/02/2011 10:13
Save the NHS

exactly the job loses are nothing and will go naturally.

Boromart Posted on 28/02/2011 10:15
Save the NHS

thin end of the wedge ABCD. Staff turnover is irrelevant.

Claiming they are pen pushers and 'failed IT' is silly. If you think it won't have an effect on front line services then you are very naive. I noticed they changed the way they calculated waiting times in A&E, why? because if you change how you report it hides the fact that your service quality is dropping. Expect a lot of this from this government.

speckyget Posted on 28/02/2011 10:15
Save the NHS

The notion that we're not allowed a nationalised health service because of "EU diktat" qualifies - in the face of stiff competition - as one of the most eccentric arguments I've read on this board.

Razmond_HWDR Posted on 28/02/2011 10:17
Save the NHS

Boromart if you class those issues unimportant clearly you havent stayed in a hospital for years.

Or you are wealthy enough to not care about the costs put on the patients at the frontline?

ABCD Posted on 28/02/2011 10:22
Save the NHS


What utter bollox. The NHS has been a mess for 30 plus years, it employs more "pen pushers" than frontline staff and is in hock to it's eye balls thanks to PFI.

Any re-organisation of the backroom staff that improves efficiency is a good thing. The tories have ring fenced the NHS budget so any savings should be reinvested in front line services.

It's time that the NHS focused on health delivery not targets and as for the whacky things you can have done at the tax payers expense.

For example how many "health" tourists recieve free treatment every year? I know at least 15 women here in KL that headed off to the UK at 6 months pregnant so that they could give birth and then returned here having not paid a single cent in uk taxes or fro there hospital stay.

speckyget Posted on 28/02/2011 10:36
Save the NHS

"it employs more "pen pushers" than frontline staff"

Do you know that for a fact, or are you just making noise there?

ABCD Posted on 28/02/2011 10:38
Save the NHS

I know it for a fact in the same way that a TUC think tank knows that there will be 50,000 job loses all front line. If you took off your rose tinted specks you know that as well.

Razmond_HWDR Posted on 28/02/2011 10:41
Save the NHS

speckyget do you think that that is wrong?

I heard something a while ago about the number of admin and management staff in the NHS compared to the frontline staff.

speckyget Posted on 28/02/2011 10:44
Save the NHS

It's just that the latest stats for NHS headcount put central functions, estates, managers and senior managers at about 230k in the Hospital and Community Health Sector, out of a total workforce of 1.2m. Still, as long as you know it as a fact I suppose that trumps any published figures.

Razmond_HWDR Posted on 28/02/2011 10:47
Save the NHS

does that count all admin staff and all management in the NHS?

Boromart Posted on 28/02/2011 10:47
Save the NHS

"The NHS has been a mess for 30 plus years,"
No it hasn't

"it employs more "pen pushers" than frontline staff"
no it doesn't

"Any re-organisation of the backroom staff that improves efficiency is a good thing."
agreed, re-organisation doesn't necessarily mean job cuts though.

"The tories have ring fenced the NHS budget so any savings should be reinvested in front line services." Should but won't

"It's time that the NHS focused on health delivery not targets and as for the whacky things you can have done at the tax payers expense."
You clearly haven't a clue what you are on about. A well defined system of KPIs that support CSFs are VITAL for an organisation to prove the efficiency and effectiveness of it's processes. The wrong kind of targets can be a problem though. It is a great concern to me that a government comes in and removes the old method of measurement, oldest trick in the book to hide that fact that you are going to reduce operation performance.

Targets drive behaviour so they need designing right, not for some political agenda. If you think targets are meaningless tell me how you would know that a huge organisation like this is working or not? Finger in the air? Clueless.

Razmond_HWDR Posted on 28/02/2011 10:49
Save the NHS

does it also include some of the controversial overtime costs some of the higher paid NHS staff can charge?

Razmond_HWDR Posted on 28/02/2011 10:51
Save the NHS

Boromart so you are in favour of NHS reforms?

ccole Posted on 28/02/2011 10:53
Save the NHS

A good friend mine works in the NHS, the tales they tell me about employees taking the piissh with sickness leave is a disgrace. The attitude of some of the staff affects moral of the staff that are committed and dedicated to the job they do.

It’s clear that its weak management as they are often fearful of starting disciplinary action because of the fear of tribunal claims and cost.

It’s a gravy train for too many who are taking funds out of the NHS and diverting them from the people the system is there to help.

Anyone who says the NHS doesn’t need some sort of major overhaul is naive

speckyget Posted on 28/02/2011 10:53
Save the NHS

Raz, doesn't include direct clinical admin eg medical records.

If you're interested the biggest single staff grouping is nurses and midwives.

edit: on the second question - no, staff numbers don't tend to show overtime payments.

Boromart Posted on 28/02/2011 10:54
Save the NHS

I'm in favour of continual improvement more than 'reform' and the risks inherent in that strategy.

Razmond_HWDR Posted on 28/02/2011 10:58
Save the NHS

basically it doesnt include admin in your numbers.

well presented for showing that admin and management costs arent as much as front line costs.

Razmond_HWDR Posted on 28/02/2011 10:59
Save the NHS

'agreed, re-organisation '

so you class a re-organisation not as a reforming but as a continual improvement?

ABCD Posted on 28/02/2011 11:00
Save the NHS

The stated figure of 51,000 by the false economy website is debatable for its truth.

First this "headline" figure includes Scotland, Ireland & Wales over which westminster has no say and once these figure are stripped out the total is more like 40,000.

They have also counted natural wastage and reduced vacancies as cuts, and have made no distinction between bureaucrats, doctors and nurse.

False Economy then admits “Most of the cuts are likely to be achieved through natural wastage rather than compulsory redundancies.”

Now heres the kicker...

A report on the NHS was commissioned by Labour in 2009 and carried out by the consultants McKinsey. It called for a 10 per cent cut in the NHS workforce – or 137,000 job cuts over three years in order to save £20bn. Oh yes and Labour promised to protect the NHS budget did they not?

Boromart Posted on 28/02/2011 11:01
Save the NHS

ccole, that is not something that is related to the NHS. It is a UK wide situation.

It is only partially related to weak management, (you get what you pay for and the best managers work in the private sector with better renumeration). Primarily it is about UK and European employment laws that apply to ALL British companies.

speckyget Posted on 28/02/2011 11:01
Save the NHS

I see, medical records a waste of time and money then raz? Or perhaps doctors, on their salaries, should look after patient information also?

Boromart Posted on 28/02/2011 11:05
Save the NHS

Razmond_HWDR, I think it is quite clear that Reform is a high risk high impact (both positive and/or negative) strategy.

re-organise is making better use of your existing resources and capabilities. It may mean some 'minor job losses', but is entirely different to a strategic drive for reduction.

Razmond_HWDR Posted on 28/02/2011 11:05
Save the NHS

i thought what ccole has been a big problem in the NHS and the media reported so only a year ago. I remember a Jeremy Vine debate about it with NHS workers coming on the radio and saying they did it because they were over worked.

Boromart are you saying it isnt that big an issue in the NHS, and is simply just as bad as every other organisation in Britain?

Razmond_HWDR Posted on 28/02/2011 11:08
Save the NHS

so you consider no reforming would be required in a re-organising of parts of the NHS?

Boromart Posted on 28/02/2011 11:08
Save the NHS

"They have also counted natural wastage and reduced vacancies as cuts"
I simply do not get this argument. It's irrelevant. It is still less resources in the NHS, and greater unemployment as the NHS reduces it's intake. The fact that people reitre rather than get made redundant is unimportant in the grand scheme of things.

Razmond_HWDR Posted on 28/02/2011 11:11
Save the NHS

speckget i never said ANY admin was a waste of time and money.

You supplied stats to support what you were trying to get across which was that admin and management are not paid more than frontline staff... but you forgot to mention you left out admin. Not sure those stats could be trusted now.

If you have 10 admin staff for medical records where it should normally take 1 admin staff do you consider that a waste of money?

Razmond_HWDR Posted on 28/02/2011 11:12
Save the NHS

'It may mean some 'minor job losses''

Boromart you may not get it but you have just admitted that jobs could be cut.

Boromart Posted on 28/02/2011 11:14
Save the NHS

Raz, 'may' and for efficiency reasons, re-organisation 'may' also create jobs. It 'may' also ensure that the right resources are available at the right time to improve service delivery. re-organization is not a synonym of job cuts, a Tory strategy of 'reform' is.

Entirely different from a strategy of reduction which is what is being employed by the Tories.

Razmond_HWDR Posted on 28/02/2011 11:16
Save the NHS

what you are saying is that you dont know what any re-organisation may produce.

maybe the government have a better idea than you.

Boromart Posted on 28/02/2011 11:19
Save the NHS

Raz, the NHS has been a thorn in the side of Tory governments historically. It is against their ethos. If they could demolish it today without losing voters they would. They want to introduce a medical service sector a la USA.

Razmond_HWDR Posted on 28/02/2011 11:20
Save the NHS

'NHS has been a thorn in the side of Tory governments historically'

do you have a gripe with the tories or with the current reforms?

like i have said you have admitted that job losses may happen in any re-organisation, so why are you against job losses?

speckyget Posted on 28/02/2011 11:20
Save the NHS

A lot to unpack there raz. My point on central functions was to counter the assertion by another poster that there are more "pen pushers" than frontline staff. Apart from the fact that "pen pushers" are a) necessary and b) cheaper than doctors, the often-blabbed populist pap that they outnumber the nursing and clinical side is simply untrue.

Do I think admin staff are too numerous? No idea really, because I don't have to run a hospital, but people who do tend not to hire them for the sake of it I think.

But the numbers of medical records people or ancillary workers is a bit of a sideshow to the reform debate to be honest. The transfer of commissioning to GPs is frankly barking (not sure where the whole public/private row got dragged into this).

Razmond_HWDR Posted on 28/02/2011 11:24
Save the NHS

what you are saying is that someone said they have more penpushers, you counted that by proving they dont by leaving out admin staff.

You also dont even know if there is an over population of admin staff in certain areas of the NHS, an issue that has been raised in the media before when labour was in power.

Boromart Posted on 28/02/2011 11:32
Save the NHS

Raz, you do realise the media in one form or another is in league with a political party to help them achieve there gains.

"The transfer of commissioning to GPs is frankly barking" -- deeply worrying. Done so that they can remove the requirement for some admin staff. The effect though is that it is placing extra work on front-line doctors, who are not admin people, it will slow them down and could be done more efficiently by dedicated admin staff.....and this isn't going to effect service quality? Like you said barking.

jam69 Posted on 28/02/2011 11:34
Save the NHS

these multi millionaire tories hate the fact that they have to pay into the nhs that they will never use do to their private health care and resent paying towards the oiks health care.especially when it could be privatized and theres money to be made.
so now they are in power its time for them(like the health sec whos on the private healthcare paylist)to make some coin,its their birthright dont you know

Razmond_HWDR Posted on 28/02/2011 11:35
Save the NHS

Boromart i see you are unwilling to answer what i have asked.

'The transfer of commissioning to GPs is frankly barking'

i would not know, i am not a GP. Some people like to keep a better account of things some dont. Where are the GPs raising issue with this??

Boromart Posted on 28/02/2011 11:36
Save the NHS

imagine how much money could be made if the NHS was abolished for a US like system? Now if you were one of the 5% who own 90% of the wealth in this country you could make an absolute killing by investing in the private health insurance and health care industries.

Razmond_HWDR Posted on 28/02/2011 11:38
Save the NHS

Boromart is that what you are protesting against, the NHS abolished for a US like system?

or are you protesting against any given reform, even though you agree with the fact some job losses may need to happen in the NHS across the country?

speckyget Posted on 28/02/2011 11:38
Save the NHS

I compared central support funtions to the total; medical records etc are classed as support to clinical and nursing. Ask a doctor if he/she wants to operate without clinical support.

Regards 'over population' as you quaintly put it, I know about as much as you, and about as much as 'the media' as regards what constitutes an adequate level of clinical support. And headcount numbers here start to become less helpful. Management COSTS (including medical records etc) run at below two per cent in the NHS - compares favourably with other healthcare providers.

Do you think GPs are adequately resourced to take on the commissioning role?

Edit - GPs will be put in the position of both purchasers and deliverers of services. I.e., the same circumstance as the Forestry Commission, which the government used as justification for the sale of its assets.

Boromart Posted on 28/02/2011 11:38
Save the NHS

Raz, they are raising this as an issue.

Regarding having a problem with the Tories or the policy. Well I have an issue with this Tory government because of it's policies. I say this as a 6 figure tax earner who 'should' be happy to have the NHS costs reduced.

Razmond_HWDR Posted on 28/02/2011 11:41
Save the NHS

'Management COSTS (including medical records etc) run at below two per cent in the NHS '

is this an admin level cost or with management grades be in the numbers that you did not consider aswell?

So you did not include all Management and Admin in the NHS?

Boromart Posted on 28/02/2011 11:42
Save the NHS

Raz, I am against a US like system which I and others believe is the long term aim.

I am against reduction of NHS purely for financial reasons especially without some tried, tested and understood (ie low risk) plans in place.

I am against large scale reforms being performed as part of a coalition, the people did not give a mandate for sweeping changes.

Razmond_HWDR Posted on 28/02/2011 11:44
Save the NHS

'NHS has been a thorn in the side of Tory governments historically'

Is this statement regarding current coalition policy as is it opinion on something more historical and nothing to do with current policy?

Razmond_HWDR Posted on 28/02/2011 11:45
Save the NHS

ahhh so this is more to do with you belief based on the tory party historically rather than the current facts?

Do the current government have NO Plans in place for NHS Reform?

speckyget Posted on 28/02/2011 11:49
Save the NHS

Without knowing what you regard as admin raz that question is impossible to answer. But if you think everyone who isn't a doctor or a nurse has no impact on the quality of patient care then you need to find another thread to clutter up. If however you have any genuine interest in this the information's all there - published on

Boromart Posted on 28/02/2011 11:50
Save the NHS

Tories are the party of low tax and small government, relative to the other major parties. It is there ethos to reduce and ultimately remove a government health service.

That isn't Tory bashing it's just fact, that as a party they want to reduce it's cost and capabilities.

The problem is by doing this you end up with a very divided society with massive increases in crime...crime is historically bigger under Tory government as they reduce support for the lower classes. NHS reforms are just another manifestation of their historical policy of reduction.

Razmond_HWDR Posted on 28/02/2011 11:57
Save the NHS

specky do you have a problem with distinguishing between management, admin, and frontline staff?

you felt the need to reply to the person who questioned the number of pen-pushers, but it would seem your stats could not fully back up what you were saying.

If what you are saying is opinion then just say so and dont back them up with false (not saying they are incorrect for what they cover) stats.

Razmond_HWDR Posted on 28/02/2011 12:00
Save the NHS

Boromart have you seen the government Plan for reform?

you suggested they dont have one yet lecture me and others on what they are about to do.

Do you know exactly what you are protesting against?

or is it just a protest against the tories in general?

'ultimately remove a government health service.'

'it's just fact'

of course it is :o)

speckyget Posted on 28/02/2011 12:03
Save the NHS

I said what the stats covered raz, and if you want to dig a bit deeper there's a whole raft of info on that information centre site (like you'll bother). I posted the numbers originally to give the lie to that tabloid $hite that the NHS is over-administered or over-managed. It isn't - either in absolute terms or compared with similar organisations. But by all means, if thinking hurts too much you can alwys vote Tory - simplistic policies for simple folk.

Razmond_HWDR Posted on 28/02/2011 12:08
Save the NHS

the so called lie was regarding admin staff and management posts.

You did not include all of these. Only when i questioned if it did include all did you point out it did not.

You dont know all admin numbers, so how do you know that the overall figure means that what was posted was a lie?

deganya Posted on 28/02/2011 12:10
Save the NHS

Give it a rest Raz, you really are becoming a bore just like Bernie

speckyget Posted on 28/02/2011 12:12
Save the NHS

Because if you add all the doctors and nurses and scientists together raz it comes to more than half. And of the less than half remaining only 'some' will be admin. Off down a rabbit hole as usual, with the JCB parked five feet away.

bill_door Posted on 28/02/2011 12:13
Save the NHS

Found it Raz.

The admin figures not included in Specky's earlier post come to 874,846. Most of them sit online all day on FMTTM (sound familiar?).

There's only 22 frontline staff in the whole of the UK.

Happy now?

Razmond_HWDR Posted on 28/02/2011 12:14
Save the NHS

ok... good point deg.

was just pointing out that by using stats that only cover certain areas of NHS does not prove something regard whole of NHS is a lie.

and for a poster to admit that job loses may need to happen through reform of somesort and admitting not knowing any details of an NHS reform plan, is strange when all they want to do is protest about reform plans and job losses.

ABCD Posted on 28/02/2011 12:15
Save the NHS

"these multi millionaire tories"

So being a labour millionaire is ok then but not if you happen to be a tory?

speckyget Posted on 28/02/2011 12:16
Save the NHS

Thanks bill, although some of those 22 will be part time, and you've excluded superannuation.

bill_door Posted on 28/02/2011 12:16
Save the NHS

Sorry specky, I was trying to beef it up a bit.[cr]

Razmond_HWDR Posted on 28/02/2011 12:25
Save the NHS

specky where did you get the 230k and 1.2million from?


speckyget Posted on 28/02/2011 12:26
Save the NHS

I've given you the website adress razmond, it's all PD stuff. But before you start digging up numbers to convince yourself that the whole NHS is hell in a handcart territory, ask yourself whether the gadge that maintains the ventilator that keeps you alive is a doctor, or whether the woman that carries out a PET scan is a 'pen pusher'. Hospitals don't exactly run like tax offices.

myboro Posted on 28/02/2011 12:30
Save the NHS

BMA fears
The BMA has issued a parliamentary briefing for MPs debating the bill in its Commons second reading this week.

It warns that forced competition, with providers able to undercut each other on price, will make it impossible to provide the best quality care for patients.

The association fears this forced competition will jeopardise the potential benefits of clinician-led commissioning.

The briefing states: ‘The BMA is committed to the founding principles of an NHS delivered in a cooperative and coordinated environment where patients are guaranteed the most clinically appropriate and cost-effective care. Price competition and a fully open market will make this impossible.’

BMA council chairman Hamish Meldrum last week wrote to health secretary Andrew Lansley to reiterate the strength of feeling among doctors leaders about some aspects of the bill.

myboro Posted on 28/02/2011 12:32
Save the NHS

RCGP Survey highlights GP concerns over NHS Reforms

1st February 2011

More than half of GPs responding to a snapshot survey carried out by the RCGP are concerned that the proposed health reforms will not lead to improvements in care for patients.

The poll, conducted via the online tool SurveyMonkey, shows that GPs are yet to be convinced that the reforms will improve patient care, enhance the relationship between GPs and consultants, or reduce bureaucracy in the NHS.

The College conducted the survey to add to its ongoing consultations with GPs on the health service reforms, and respondents were asked their views on four main areas:

* GP Commissioning
* Any Willing Provider
* NHS Infrastructure
* Direction of travel of reforms

The poll attracted more than 1,800 responses. Over 50% disagreed that the proposed model of GP commissioning would create a patient-led NHS. More than 70% of respondents said they disagreed- or strongly-disagreed that the concept of ‘Any Willing Provider’ would either achieve a patient-led NHS, or improve healthcare outcomes.

RCGP Chair Clare Gerada said:

“The RCGP is not opposed to NHS reform; we want to improve the NHS for our patients, and GPs want to see a clinician-led NHS that places patients at its very centre. However, these results highlight the continuing concerns many of our members have about the proposals outlined in the Health Bill.

Link: Royal College of General Practitioners

myboro Posted on 28/02/2011 12:37
Save the NHS

Raz, Doctors, Nurses, Health workers etc have all made it clear that these proposals will not achieve the stated goal.

BUT it will happen because this reform is about the NHS being opened u[p to the private sector - everything opened up for profit.

It is not about a patient led NHS it is about dismantling the NHS and letting private health companies generate profits from your taxes.

The rush is because of the money involved - too big an earner for thias to be discussed properly

Razmond_HWDR Posted on 28/02/2011 12:41
Save the NHS

speckyget no need to be rude. I think you need to have a look at the qualifications of those people to tell if they are pen pushers or not, mind i presume you are not that simple that you dont already know. [^]

speckyget Posted on 28/02/2011 12:47
Save the NHS

I wasn't aware I was being rude razmo. My humblest apologies for any unintentioned brusqueness. But I would say a hospital is a complex organisation. If you don't know how they run (and I'm not saying I do fully either) it's difficult to generalise on what's essential and what isn't, which I guess is what's behind your interest in 'admin' and the other poster's nonsense about 'pen pushers'. I'd suggest there are some doctors and nurses whose roles aren't exactly life critical, and these will be amongst the highest paid.

Razmond_HWDR Posted on 28/02/2011 12:51
Save the NHS

are you saying that some frontline staff are maybe not critical?

hasnt the concern allows been that more front line staff are needed and less admin and management.... are you saying this is not the case and maybe losses could be made from both the frontline and admin and management areas of the NHS?

Boromart Posted on 28/02/2011 12:56
Save the NHS

"Boromart have you seen the government Plan for reform?

you suggested they dont have one yet lecture me and others on what they are about to do."

I didn't suggest that they don't have a plan for reform, I suggest that they are ill-concieved plans OR more abhorently they know that their will be negative effects because ultimately they want the NHS's capabilities to be less. More people will be forced to move over to the private sector and eventually they will have manufactured a situation where there would be less resistance to a sell off and shut down the NHS.

Midosparmo Posted on 28/02/2011 13:00
Save the NHS

Calm down Mart. Its political suicide in this country to even dare to think of abolishing the NHS.
There will be ways to reform it and make it more efficent im sure. However I wouldnt trust any politicians of any party to be able to organise a p1ss up in a brewery let alone reform the NHS.

Razmond_HWDR Posted on 28/02/2011 13:00
Save the NHS

i noticed that from the stats on the web site that the nhs has been running up a cost month by month of employing more than 1000 staff each month, thats over 12,000 staff since 2009 - 2010.

i could not find the 239k amount anywhere so was unable to confirm that stat.

speckyget Posted on 28/02/2011 13:01
Save the NHS

I'm saying find out how the NHS works before pontificating what jobs are and are not essential.

230k is a headcount figure, not a cost figure.

heaton_mersey_boro Posted on 28/02/2011 13:06
Save the NHS

If the NHS is privatised, how will it work?

In the USA do they pay a lot less tax, but have to pay for their medical treatment?

In this country we would still pay tax at the same rate, yet have to pay for the privelage to use a hospital - ie like you can do with BUPA etc?

For the record I have'nt a fóóking clue how the NHS works, however reorganisation done correctly "somehow" may give improved service / savings?

Privatise the NHS and we'll be in the same situation in 20 years as we are now with regards to the utility companies / rail network etc. Happy days.....[DFS]

Razmond_HWDR Posted on 28/02/2011 13:09
Save the NHS

specky lets get this straight, you are saying that until we fully understand the organisation that is the NHS and have seen the government NHS reform plans we shouldnt judge?

Boromart Posted on 28/02/2011 13:10
Save the NHS

Midosparmo, Tory policy is to slowly weaken it towards ineffectiveness. Then the appetite for keeping it will diminish.

You are right that it would be suicide to completely get rid (at the moment), but to 'reform' into something that doesn't resemble the free healthcare for all that we are used to is the first step towards that goal.

speckyget Posted on 28/02/2011 13:18
Save the NHS

Raz, it's not difficult. If you want to class a job as superfluous it helps if you understand what that job does, and how it contributes towards the eventual outcome of good quality patient care and improved public health. Simplistic classifications such as 'admin' or 'pen pusher' or 'doctor' aren't particularly illuminating.

Same with reform. Lansley was Secretary of State for ten minutes before publishing his plans - no consideration or consultation. Do you think they are likely to be successful? The BMA and RCGPs (people who represent opinion that's even better informed about the NHS than idiots like us on a message board) seem to think not - see myboro's posts above.

Razmond_HWDR Posted on 28/02/2011 13:20
Save the NHS

'230k is a headcount figure, not a cost figure. '

so where the stats i gave.

where did you get that stat from, which document, was it covering an annual basis or a monthly one?

speckyget Posted on 28/02/2011 13:22
Save the NHS

Provisional Monthly NHS Hospital and Community Health Service (HCHS) Workforce Statistics in England

Razmond_HWDR Posted on 28/02/2011 13:28
Save the NHS

are you suggesting now that your stats are even less relevant to this than before? That maybe within those numbers many frontline aswell as admin and management job could actually be superfluous? We dont know as we dont know the detail.

Should we PROTEST against something the WE do not know the detail to yet?

Razmond_HWDR Posted on 28/02/2011 13:32
Save the NHS

do you mean 'NHS infrastructure support' ?

skiprat Posted on 28/02/2011 13:37
Save the NHS

Is it wrong to want to kill myself after reading Raz's obtuse contributions to this thread?

speckyget Posted on 28/02/2011 13:38
Save the NHS

Seriously raz, if you want to understand the NHS go and work in it for a bit.

Razmond_HWDR Posted on 28/02/2011 13:45
Save the NHS

you are saying that until we fully understand the organisation that is the NHS and have seen the government NHS reform plans we shouldnt judge?

do you even know what 'NHS infrastructure support' refers to i.e. how much is contracted out etc?

speckyget Posted on 28/02/2011 13:51
Save the NHS

Contracted out staff aren't included in publish headcount figures. You've just gone into autorespond now raz.

However if you're posting for the sake of it, riddle me this - what is your response to myboro's posts earlier outlining the healthcare professionals' serious misgivings about the reforms?

Razmond_HWDR Posted on 28/02/2011 13:53
Save the NHS

can you answer this first ...

... you are saying that until we fully understand the organisation that is the NHS and have seen the government NHS reform plans we shouldnt judge?

Razmond_HWDR Posted on 28/02/2011 13:57
Save the NHS

i meant the term, i.e. Infrastructure within defence in the main is contracted out work.

We are talking about those sort of jobs being not needed anymore right, or is this another area you are unsure of?

speckyget Posted on 28/02/2011 13:58
Save the NHS

I'd say if I was commenting on arses and elbows it's a sensible plan to distinguish between the two first, yes. But before you respond to the previous you might reflect that the BMA and RCGP represent folk who understand the former and have seen the latter.

And you still haven't said anything about resources for GP commissioning, but I'm sure that's an oversight.

Edit wtf was that last post about? If they appear on that analysis they're staff, not contractors. What's defence got to do with it? Don't answer. For God's sake don't answer.

Razmond_HWDR Posted on 28/02/2011 14:02
Save the NHS

ok fantastic, now are you suggesting that the people who do not know what is going on and have not seen the reform plans should sign a petition protesting regarding reform plans they have not seen yet?

Bernie_is_banned Posted on 28/02/2011 14:03
Save the NHS

Smuggy is right. He's always right. Everyone else is wrong. Sooner you understand that the better.

speckyget Posted on 28/02/2011 14:03
Save the NHS

No, you unutterable dunce I was suggesting you address yourself to myboro's posts above. One of the more polite suggestions I could think of.

Midosparmo Posted on 28/02/2011 14:03
Save the NHS


Razmond_HWDR Posted on 28/02/2011 14:03
Save the NHS

Do YOU know what 'NHS infrastructure support' are?

You related them to the so called penpushers

do you know what they do?

Razmond_HWDR Posted on 28/02/2011 14:06
Save the NHS

fantastic, i guess you agree with me in the thinking that the first post on this thread is wrong, because until we know the detail of the reforms we do not know what we are protesting against.

Razmond_HWDR Posted on 28/02/2011 14:11
Save the NHS

right well, firstly the press release goes into no great detail, so i have very little to comment on, and again as i have not seen the proposed reforms and how they are to work i have nothing to base what they have worries against.

But I see all sectors within Public Sector are having to make such changes with admin and budgets being shifted to rebalance structures and yes save costs.

This is just another example.

But they may have very valid concerns and i hope they are addressed by the government, of course the biggest worry is privatisation.

speckyget Posted on 28/02/2011 14:12
Save the NHS

The White Paper was published last year.

PS Hiya Bernie, what does Gaunty or Littlejohny or Bushelly think about the NHS reforms? I'm sure that via your right mouse button their thoughts would illuminate this debate.

Razmond_HWDR Posted on 28/02/2011 14:15
Save the NHS

have you read it?

i wonder if BoroMart has with the preconceptions regarding Tories he has.

Boromart Posted on 28/02/2011 14:22
Save the NHS

speckyget, spot on. These policies are clearly not about improving efficiency.

best practice:
1 - Where are we now?
2 - Where do we want to be?
3 - How do we get there?
4 - Did we get there?
5 - keep the momentum going/

If you don't do number one then you stall at number 3 and number 4 and 5 WILL fail.

Of course if the aim is simply "reduction of cost, regardless of the negative effect on service quality" then you can do 1 based on the previous years budget figures.

This is nothing but the start of a downsizing operation.

Razmond_HWDR Posted on 28/02/2011 14:23
Save the NHS

what is bad about what is in the White Paper?

it does not mention anything in great detail, i imagine someone who knows the system better will pick up on issues.

But costs could be cut, 4% required at least.. is the down size i guess.

speckyget Posted on 28/02/2011 14:29
Save the NHS

There you go raz. If it keeps you occupied for ten minutes.

Link: Glorious Five Year Plan

Razmond_HWDR Posted on 28/02/2011 14:33
Save the NHS

read the emails speckget.

i have read it, and you are right 10mins reading, thats great detail.

Where does it say it is all about reducing costs?

Please see councils cuts and defence cuts and cuts to the arts and education cuts, these are the biggest areas at risk.

myboro Posted on 28/02/2011 14:34
Save the NHS

Raz - the white paper basically sets out how the NHS will be privatised. Everything will be contracted out and for all the bluster about GP's leading the reform they can be overridden if they dont let private companies in.

Its not about costs as such, its about private health companies (like the one who sponsers the tory toff) being able to get thier hands on NHS cash.

Stop being an idiot and let those with a concience sign the petition

speckyget Posted on 28/02/2011 14:37
Save the NHS

Why do you think medical professionals are so concerned about it raz?

Razmond_HWDR Posted on 28/02/2011 14:42
Save the NHS

you mean contracted work like we have in many other sectors?

or do you mean the whole of the NHS being private? Because it clearly does not state that in the white paper.

Boromart Posted on 28/02/2011 14:43
Save the NHS

these Tory's are barking. "Success will be measured, not through bureaucratic process targets, but against results that really matter to patients – such as improving cancer and stroke survival rates. " - They appear to be advocating removal of all operational and tactical measuring!! This is very poor practice. This will lead to further inefficiencies down the line.

This will increase inefficiencies and make management decision making near impossible. "You can't manage what you don't measure", how on earth is a manager to know how well his staff are working, if the processes require improvements, or anything? it will turn management into guesswork.

Razmond_HWDR Posted on 28/02/2011 14:47
Save the NHS

speckyget you are asking me to answer on the details of reforms, something you have told me not to speculate on unless i kno the details about how ths NHS currently runs.

Again are you suggesting we should sign up and protest about something we do not know exactly what the issues are? You yourself said you did not know the details of work loads and ratio of staff per job. Maybe it is best for a GP to manage that rather than someone who does not know as well as them.

I agree they will know better than me, but i wont protest off the back of their protests alone.

I think the Real Time cuts in other areas will be much more hard hitting.

Razmond_HWDR Posted on 28/02/2011 14:50
Save the NHS

are Targets always best practice?

should budgets be measured, success rates be measured, times waiting be measured without setting targets that MUST be met?

speckyget Posted on 28/02/2011 14:51
Save the NHS

OK Raz, now you've read the White Paper, what do you think about GP led commissioning?

Midosparmo Posted on 28/02/2011 14:55
Save the NHS

Personally I reckon gps will be as clueless as Mps [^]
Theres only one letter diference anyway.

All I do know is those that get some power like mps and soon gps are the ones that get rich from it.

Boromart Posted on 28/02/2011 15:00
Save the NHS

In answer to your question, targets should exist, I have no problem with that. Not sure what that has to do with this proposal though. You seem to be missing the point.

They are purely having outcome based targets. That means that decisions on process can be made that don't surface for years into those outcome figures. Even then it is very hard to attribute improvements or failures in those figures to the original causes...because you are not measuring them.

Example Scenario:

GPs will be handed further admin work, this is a process change. This leads to lower quality data in the system, and lower efficiency of the expensive GP resources.

But because some new cancer drug becomes available at the same time we see an improvement in the cancer survival rates.

The government say look how brilliant we are, yet it is nothing to do with them, and the survival rates SHOULD have been higher but for mistakes made by GPs due to process changes.

It is absolute madness, and against best-practice, period. Only an imbecile would run an organisation purely on outcome based metrics.

Razmond_HWDR Posted on 28/02/2011 15:05
Save the NHS

do we have such details on such things as commercial responsibility, and contract negotiating responsibility?

in Defence units will manage a budget but they will never be involved in the commercial negotiating or contract responsibility, that is done at a higher level of authority.

speckyget Posted on 28/02/2011 15:08
Save the NHS

The higher level of authority is being removed to save money. It is 'expected' that somehow GPs will band together into groups of 'super purchasers'. No money allocated to facilitate this though.

Razmond_HWDR Posted on 28/02/2011 15:10
Save the NHS

wasnt an Example Scenario given on the bbc before regarding this that the GPs will just pass the admin work on to contractors to do.

This would mean same staff on less wages... its terrible.

Razmond_HWDR Posted on 28/02/2011 15:12
Save the NHS

they will be both commercial and contract based?

are you sure because in defence and any where else in public services to work in commercial and work on the contract is a conflict of roles?

are you suggesting that all GPs will manage their budget, manage commercial negotiations and manage conracts?

Razmond_HWDR Posted on 28/02/2011 15:14
Save the NHS

sorry one more thing, i thougt the high level that was taken away was them managing their own budget... not having contractual and commercial responsibility.

bill_door Posted on 28/02/2011 15:58
Save the NHS

"wasnt an Example Scenario given on the bbc before regarding this that the GPs will just pass the admin work on to contractors to do.

This would mean same staff on less wages... its terrible."

Razzles, do you really think that passing on rather vague 'admin work' to contractors will mean it's done by staff on less wages?

Have a look at the wages on offer for NHS clerical positions. Passing it on to a contractor i.e. agency staff will cost more. The other difference is that you don't have experienced staff doing that work, you have temps who will need training up on the procedures and computer systems.

speckyget Posted on 28/02/2011 16:19
Save the NHS

Raz, the contracting and contract management functions to which you refer are carried out by Primary Care Trusts at present. These will be abolished by 2013 and those functions devolved to GPs, who also deliver primary care services. See my post on this earlier in the thread (about ten years earlier I think).

Dibzzz Posted on 28/02/2011 16:21
Save the NHS

'It's for the best'

You wouldn't be saying that if you relied on it like many thousands do.

zorro_mfc Posted on 28/02/2011 18:19
Save the NHS

I wonder how many of those praising the US system have actually used it, I was over in the US last year and whilst walking along the sidewalk/path (or what passes for one in the US) I suffered a small injury resulting in a few stitches and a tetanus shot nothing major, the friends i was staying with took me to a nearby hospital needless to say 30 mins later once my insurance details had been approved (first stop in a US hospital is with the financial department - so how are you going to pay...?

Half an hour later i was all patched up, on arrival to the Uk the bill arrived for the procedure for 1 tetanus shot and a half a dozen stitches the cost was ... $1030.00

I have friends who work in the medical profession in the US and i asked how people without insurance coped in a similar situation and their response was pretty chilling... They are bound as health professionals to give a duty of care (regardless of finance) but as they termed it yes if you were wounded you be treated by the hospital but it would be a basic patch up you wouldn't die in the Er but you prob would in the car park and there is no follow up care either.

Then we have the pre existing condition loophole as well so even if you insured you may still be denied.

Greatest system in the world? That depends on your finance. For those with money it is superb but for those with out well.... theres always the car park

Corcaigh_the_Cat Posted on 28/02/2011 18:27
Save the NHS

That's about right.

ZippytheHippy Posted on 28/02/2011 20:40
Save the NHS

I notice that the "left" leaning faction is ignoring what ABCD posted regarding the source of these NHS "cuts", why is that?

Corcaigh_the_Cat Posted on 28/02/2011 21:52
Save the NHS

You don't cut back an essential body that needs improving, regardless of Micky Mouse surveys.

Razmond_HWDR Posted on 01/03/2011 07:23
Save the NHS

speckyget are you seriously saying that from 2013 all GPs will be required to do comercial activity aswell as manage budgets and do there GP work?

Do you realise to do commercial work you require a recognised Commercial Qualification to do any negotiating.

Will all GPs be required to train to do commercial work?

Razmond_HWDR Posted on 01/03/2011 07:25
Save the NHS

bill door who has said it will be temp agency staff who take over the work?

I know public sectors where depts have been privatised to contractors so the government get cheaper labour than they would for public sector workers.

Bernie_is_banned Posted on 01/03/2011 08:05
Save the NHS

"I know public sectors where depts have been privatised to contractors so the government get cheaper labour than they would for public sector workers."

Soumds like good value for the tax payer [^]

Razmond_HWDR Posted on 01/03/2011 08:06
Save the NHS

I have looked into this this morning and yes the PCT are going which is why the responsibility is moving to the GP.

However the PCT never had any commercial contract negotiating powers, they are done by other NHS agencies, and it would seem that process will continue and will be now called upon by GPs. I also imagine that any management of contracts will be done by these agencies, possibly even low value purchases will be done by them.

The GPs will simply have a budget to manage, and of course for some having to do this creates a new way of understanding. And I am surprised that they do not have to undertake any sort of financial bookkeeping qualification in preparation for this. But they DO NOT have the responsibilities of contract management and commercial negotiating and decision making

speckyget Posted on 01/03/2011 10:32
Save the NHS

I don't know where you looked raz but I don't think that's right. The contracts between PCTs and Acute Trusts are just that - contracts. The people who let them and manage them are commercial specialists. Sometimes you will get a standard bulk contract that consortia of PCTs put together to cover a geographical area. How GPs will manage to generate equivalent coverage, or what will happen to the procurement people in PCTs is not yet clear.

Razmond_HWDR Posted on 01/03/2011 10:39
Save the NHS

Changes on the way...
As part of the budgetary constraints, the NHS is facing significant reorganisation. Under plans, announced in early July, all 10 strategic health authorities and 152 primary care trusts are to be abolished, saving the cost of employing around 60,000 managers. Responsibility for health budgets will pass directly to GPs. With pilots likely to be in place by the end of 2010 and the system to be fully in place by April 2013, those wishing to sell to the NHS will have to consider and get to grips with new audiences.

Aside from the need to ensure that products and services meet the price expectations of the NHS, suppliers also need to work through a maze of procurement rules and regulations.

Generally trusts purchase through a number of channels, including:
· individual trusts' local contracts
· national framework contracts negotiated by Buying Solutions Health (previously overseen by the NHS Purchasing and Supply Agency)
· national framework agreements managed and negotiated by NHS Supply Chain
· consortium contracts, where a group of trusts work together to negotiate contracts – often developed into collaborative procurement ‘hubs’
· pan government contracts

speckyget Posted on 01/03/2011 10:43
Save the NHS

I think you're confusing supplies procurement and commissioning of healthcare services. Both covered by contracts and managed by commercial specialists.

Razmond_HWDR Posted on 01/03/2011 10:46
Save the NHS

thats what i said, managed by commercial specialists.

Do you still think the GPs will take on the commercial responsibility?

speckyget Posted on 01/03/2011 10:48
Save the NHS

There is no-one else to in the new structure - PCTs and the remaining SHAs will be abolished.

Razmond_HWDR Posted on 01/03/2011 10:51
Save the NHS

so you think GPs WILL have commercial responsibility, will have to negotiate and re-negotiate contracts?

speckyget Posted on 01/03/2011 10:55
Save the NHS

In consortia, yes they will. That's what healthcare commissioning is. The 'supplies' side of things will continue as now (which is far from ideal, as PASA doesn't have any spending power).

deganya Posted on 01/03/2011 10:55
Save the NHS

The GP's are being asked to do this task, they don't want to do it, hence they will need management companies to carry out this very luctrative job, I mean spending 80 billion of our money isn't going to be easy. I wonder how many Tory MP's and friends of this Government will be on the boards of these 'management' companies? Its just a way of distributing huge amounts of public wealth back to the rich, which is what the tories have always done.

Razmond_HWDR Posted on 01/03/2011 10:58
Save the NHS

speckyget are the GPs being asked to manage their own budget?

are they also being asked to manage contracts in place and monitor the running of them i presume with some sort of KPI Regime?

Are they also being asked to negotiate and re-negotiate potential contracts with many bidders handling sensitive commercial issues?

speckyget Posted on 01/03/2011 11:01
Save the NHS

In consortia, yes. Those functions will devolve to that layer.

Edit - some GPs have managed their own budgets since the 1980s btw.

Razmond_HWDR Posted on 01/03/2011 11:07
Save the NHS

what exactly do you mean by in consortia?

i.e. you need admin staff bringing in to support your role as a GP, you need to put the contract out to tender ... who does that?

r00fie Posted on 01/03/2011 11:12
Save the NHS


speckyget Posted on 01/03/2011 11:14
Save the NHS

The consortia will have to a) form and b) try to sort out how to manage the huge budget suddenly coming their way. As mentioned above the ill judged haste will mean management companies coming in to fill the void in some cases. It's not clear how/whether it will work effectively in practice, or more to the point how this activity will be funded.

Razmond_HWDR Posted on 01/03/2011 13:18
Save the NHS

you still have been unable to explain the process

is the consortia incharge of just one practice or is it in charge of an area, which would again takes decisions away from the practice and the gp?

Who has the commercial qualifications to tender a contract?

speckyget Posted on 01/03/2011 13:27
Save the NHS

At the risk of you seeming dense raz, I've explained where the responsibilities will lie about five times. HOW GP responsibilities will be discharged has not been established - laissez faire government.

susy Posted on 01/03/2011 13:33
Save the NHS

I saw a GP being interview on the news the other week. He was telling us that having the GP's meant that it cut out the middleman as in the PCT, therefore it would be cheaper, he said it would be between him and his administrators that made the decisions..... erm his administrators...erm you mean more middlemen????

The idea of GP's holding the money is a good one in an ideal world, unfortunately this isnt an ideal world. There is talk about GP's being incentivised to not spend money.

There is waste in the NHS however its about time the bloody polititians stopped playing with this very important institution and took a really good look at it. The last government made many improvements such as bringing waiting lists down. However, they also did some REALLY stupid things like say to GP's they could earn more money if the put certain services into their practices such as diabetic care and other stuff, many GP's were already doing this so this just meant that the tax payer payed significantly more for the same level of service. They also tried to incentivise consultant surgeons by paying them more to do less. They didnt set out to do that but they put in rules and regs to try and get the consultants to work more hours than full time.... they did that anyway for no more money!! A typical tale of the polititians not having a clue of what actually happens within a service that they are meddling with.

God help our future.

Razmond_HWDR Posted on 01/03/2011 13:34
Save the NHS

you havent really. you have mentioned this consortia, but what level are they at? If a gp wanted admin staff would they have to get authority approval via this consortia?

Will GPs have to be commercially qualified? As Commercial Officers do in other sectors.

Razmond_HWDR Posted on 01/03/2011 13:37
Save the NHS

i think GPs holding their own budgets is a good idea.

I think them managing contracts and monitoring through a KPI Regime is taxing to say the least.

I think for them to have to negotiate and tender for new and renewal of existing contracts is wrong, they would have to have a specialised qualification in that area for a start.

susy Posted on 01/03/2011 13:40
Save the NHS

What services do you see getting cut?

There is lots of really scarey things I will imagine will be put forward by people who havnt been working in a hospital for many the GP's

Razmond_HWDR Posted on 01/03/2011 13:45
Save the NHS

i dont know.

I work with large contracts in the public sector, so i just have more of an idea how that all works, so am aware that if what speckyget is saying about ALL responsibility for the contracts, commercial and otherwise go to the GP they will not be able to cope and wont be qualified. If they only get the budget to manage, i see that as a good thing, they will be responsible for that.

KobeB Posted on 01/03/2011 13:47
Save the NHS

I'd like to see the NHS serve good quality nutritous foods that actually help fight and prevent diseases and not the XXXXXXe they get now.

speckyget Posted on 01/03/2011 13:55
Save the NHS

Again, raz, you're confusing supplies purchasing and healthcare commissioning. However BOTH need professionally qualified procurement personnel, so these new consortia should hire them - except it isn't clear whether the money saved from scrapping the PCTs and SHAs will be reinvested to allow them to do this, or it will have to come from their service allocation.

Tell you what - ask your MP how it's supposed to work, or write to the Department of Health. That's what they're there for.

Razmond_HWDR Posted on 01/03/2011 13:59
Save the NHS

are you saying that in the detail it does not mention anywhere who will monitor and KPI these contracts, and who will tender for them and commercially aprove them?

you are right i do not exactly understand where you are now coming from.

Are you suggesting they get a private company in to run the commercial side?

who decides which company is commercially viable?

if you do not know the answers to such questions that is fine. But I do not know how we can say this responsibility passed to the GP's is wrong when again we do not know the detail

speckyget Posted on 01/03/2011 14:13
Save the NHS

It's wrong, because as you rightly say there is a whole raft of commercial activity from tendering and contract negotiation through to management and performance monitoring that simply won't 'go away' because you happen to have abolished the organisations that did it. How - and indeed whether - this will be funded under the new regime is far from clear. In any case, you should be doing this sort of stuff at a sufficiently aggregated point to be efficient. Sort of what the PCTs do now.

Razmond_HWDR Posted on 01/03/2011 14:22
Save the NHS

do the PCTs have commercialy qualified staff there?

clearly we do not know all the details, what you think is going to happen i cannot see it being viable, so i am not sure it will happen.

the Budgets moving to GPs is a good thing. The rest i would need to see details before commenting either way

speckyget Posted on 01/03/2011 14:36
Save the NHS

Half way down the linked article. Yes, there are procurement staff at PCTs, and morale there obviously not good.

Link: link

Razmond_HWDR Posted on 01/03/2011 14:56
Save the NHS

'we don’t know at the moment what’s likely to happen or what configuration there’s going to be of GPs. For staff working within the commissioning arms of PCTs, redundancy is creating a stressful situation.” '

Thats the point we just dont know yet.

I can understand it being a worrying time as it is across the public sector, but until we know the detail of what will happen it is hard to protest against what we dont know.

speckyget Posted on 01/03/2011 15:02
Save the NHS

We know that a) the government are looking to save money by eliminating PCTs and SHAs, so it is unlikely that the same resources will be available for procurement activity; and b) that devloving a strategic function to a sub optimal level makes zero sense.

Razmond_HWDR Posted on 01/03/2011 15:05
Save the NHS

we know in defence that a lot of Divs will be going that does not mean the work load will go down a level to the bdes, they are instead centralising certain things and creating HUBs.

i think with the NHS you presume too much too quickly so you can protest.

superstu Posted on 01/03/2011 15:10
Save the NHS

Cracking discussion this. The government are getting rid of a load of staff at the NHS.

It's okay though, and we shouldn't be concerned about it, because at this point in time the government have absolutely no idea who is going to do that work instead.

Phew! So long as they have no idea what they're about to do then that's okay!

speckyget Posted on 01/03/2011 15:16
Save the NHS

The commissioning function is at about the right level now razmond, after decades of tinkering. Fannying about with it will either sub optimise (bad) or - because of lack of funding - remove it (much more bad).

Razmond_HWDR Posted on 01/03/2011 15:23
Save the NHS

so why according to that link have things failed with procurement?

speckyget Posted on 01/03/2011 16:25
Save the NHS

That link's about a different kind of procurement having 'failed' - i.e., supplies.

Razmond_HWDR Posted on 01/03/2011 20:31
Save the NHS

GPs will not be managing that procurement?