The Politics Thread

[Bijou Bob]

Yes. I think he's a rather decent chap actually.

[Lost Leopard Spot]

Yes. I think he's a rather decent chap actually.

Nice retort.

[Lost Leopard Spot]

Oh yeh, and nearly forgot, last night on 'celeb' University Challenge, the leader of the UK's newest political party, The Women's Equality Party (founded by Sandi Toksvig) didn't know the answer to who was the first woman in space.
Made herself look like a bit of a prick. (pun intended).
Answer by the way: Valentina Tereshkova.

[Harry Genshaw]

Ayatollah Corbyn. Idealogical poodle of Iran and Hezbollah, anti-Zionist, reluctant persecutor of anti-semites in his own party.
Anybody want to defend him?

What's he done?

My attention today has been focused on the NHS cancelling ops. The PM says we've never been as well prepared for a winter before. Which sorta begs the question - how the feck has this happened?

We can't blame Brexit, the Govt say it's not their fault so is it us? Are we as generation snowflake pitching up to a&e more than we used to? Or is this the reality of austerity kicking in?

[Lost Leopard Spot]

Sorry, not dodging, but just discovered yesterday's news.
"I've got a bigger button than yours... and it works".
A) amusing
B) quite profound
C) what better retort was to hand?

[TANGODANCER]

Oh yeh, and nearly forgot, last night on 'celeb' University Challenge, the leader of the UK's newest political party, The Women's Equality Party (founded by Sandi Toksvig) didn't know the answer to who was the first woman in space.
Made herself look like a bit of a prick. (pun intended).
Answer by the way: Valentina Tereshkova.

A long-standing view with me: There's rarely such a thing as equality in anything. It ususally means role reversal. Since when did "We shall overcome" not mean exactly what it says? If that party ever gets in, buy yourselves a butler's uniform..

[boltonboris]

Ayatollah Corbyn. Idealogical poodle of Iran and Hezbollah, anti-Zionist, reluctant persecutor of anti-semites in his own party.
Anybody want to defend him?

What's he done?

My attention today has been focused on the NHS cancelling ops. The PM says we've never been as well prepared for a winter before. Which sorta begs the question - how the feck has this happened?

We can't blame Brexit, the Govt say it's not their fault so is it us? Are we as generation snowflake pitching up to a&e more than we used to? Or is this the reality of austerity kicking in?

Article here from 17 years ago (October 2000) during the last Labour Government

It reads exactly like reports today. In fact today, you could copy and paste it, tweet it and watch Corbyn and McDonnell grin

I think the issues within the NHS go way beyond just funding. The more it's given, the more it will waste. 4 successive governments have not been able to stop the slide. It's the Bolton Wanderers of Public Services and it is far too easy to just say that at this moment - "you're the Government, you fix it" when previous ones have not been able to

EDIT: http://www.telegraph.co.uk/news/uknews/ ... inter.html

Link now added

[Abdoulaye's Twin]

Boris is right. UK governments are (as UK businesses are) very short termist in virtually everything. It's all about getting elected and re-elected every 4/5 years. The only way to fix it is a long term special committee of MPs and stakeholders from members of the public to NHS staff and so on. Make it non-party political and decide what we want the NHS to do and how, then properly cost and fund it. Future fund it through proper independent assessment, rather than what the government of the day wants to do for short term political gain/ideology. Nobody likes paying tax, but if people can see that it's being spent effectively on things that make a difference, then we shouldn't piss and moan too much.

[Bruce Rioja]

Create a free resource and you create unlimited demand. I think a few/ a great many people actually need to look a little closer to home and how they abuse the NHS as a birth right before slagging it off.

[BWFC_Insane]

Ayatollah Corbyn. Idealogical poodle of Iran and Hezbollah, anti-Zionist, reluctant persecutor of anti-semites in his own party.
Anybody want to defend him?

What's he done?

My attention today has been focused on the NHS cancelling ops. The PM says we've never been as well prepared for a winter before. Which sorta begs the question - how the feck has this happened?

We can't blame Brexit, the Govt say it's not their fault so is it us? Are we as generation snowflake pitching up to a&e more than we used to? Or is this the reality of austerity kicking in?

Article here from 17 years ago (October 2000) during the last Labour Government

It reads exactly like reports today. In fact today, you could copy and paste it, tweet it and watch Corbyn and McDonnell grin

I think the issues within the NHS go way beyond just funding. The more it's given, the more it will waste. 4 successive governments have not been able to stop the slide. It's the Bolton Wanderers of Public Services and it is far too easy to just say that at this moment - "you're the Government, you fix it" when previous ones have not been able to

I'm afraid that isn't the case. By an awful lot of metrics. The Tories are making the NHS worse. For example:



Lets contrast that with a waiting times metric under the last Labour government.



And lets look at health spending changes over those periods.



The plain fact is that the Tories a) underfund the NHS b) blame the NHS for underperformance c) meddle unnecessarily with it and cause further under performance.

The Tories want to privatise it. So every Tory government strangulates it and blames the service (rather than the very, crystal clear fact that Tory governments destroy the NHS) to try and hoodwink the public into further privatisation.

For all the mistakes Blair made, he funded the NHS and other public services properly. The improvements in the NHS during that time were staggering. See the rise in walk in centres and state of the art mobile units. Reducing waiting times and improving the service. The Tories have (as they always do) dragged it backwards and its worse now than the state they left it in.

The argument that money is "wasted" is a moot one. Firstly because in any large organisation you can and will find anecdotal instances of perceived waste. But secondly and most importantly because often what is reported as "waste" is not down to the service or its direct management but due to wider interference and policy direction from the DoH.

[Bruce Rioja]

As a complete aside, here's a one. I'm just discussing with a colleague about workers going on strike (apropos nowt). I have it in the recesses of my mind that some bunch (possibly Ford) once walked out because there wasn't enough cheese rolls to go round in the canteen. I can't find anything on the interweb though. Did this actually happen or have I dreamed it up?

[Abdoulaye's Twin]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

[BWFC_Insane]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

That system is one that was actually being implemented via Labour's very ambitious but ultimately flawed NHS IT re-vamp.

There were a lot of issues it threw up. For example such a system relies on everyone being comfortable having their health records centrally. Millions of people aren't and opt out. Also many IT challenges. What happens when systems go down? In essence much of this does exist. When you go to the hospital they have some of your health records on their systems (in the past all they had was the referral letter from your GP). There is a form of centralised IT but it hasn't gone as far as it should, but its incredibly complex.

Beyond IT the Tories wanted to have the "go to any GP anywhere" model. But abandoned it because practically its impossible to manage. A GP practice accepts the number of registrations it can support. For example a GP practice in central Manchester may choose to accept local residents and workers IF it can support that. (Though some practices still refuse to accept out of area registrations because of the issue of house visits). However, a totally open and free model means GP's in some areas would be swamped. And remember GP practices are in essence privately run. So you cannot easily manage that supply and demand centrally.

[TANGODANCER]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

Would that it were all that simple, A.T.. What's the policy on those who can't/wont contribute, let em die? The non-contributers are, and always have been, a fact, way of life. It's very hard to adopt a fair shares for all policy when all aren't prepared to share. Dodgers, lead-swingers and grabbers have, and are ruining the system in many areas of life, this is a fact, and the government's answer is "drop it like a hot cake" privatisation on everything to get problems off their desks. Despite hardly ever having used the N.H.S (certainly never abused it) I have every reason to see its worth. My wife has worked in nursing and also has cause to be grateful for operational help with limb problems. Hey, we need it from the first day we're born. Then again, having worked and paid tax and insurance all my life I'm allowed a view on it. Bruce made the point about free sources and unlimited demand and that sums up the N.H.S and it's problems in a nutshell. It was instituted for and in a country - still one of the finest and most forward in the world- that could sustain it. It no longer can due to demand exceeding supply. That's the simple part of it. Britain has become a year-long January sale.

[BWFC_Insane]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

Would that it were all that simple, A.T.. What's the policy on those who can't/wont contribute, let em die? The non-contributers are, and always have been, a fact, way of life. It's very hard to adopt a fair shares for all policy when all aren't prepared to share. Dodgers, lead-swingers and grabbers have, and are ruining the system in many areas of life, this is a fact, and the government's answer is "drop it like a hot cake" privatisation on everything to get problems off their desks. Despite hardly ever having used the N.H.S (certainly never abused it) I have every reason to see its worth. My wife has worked in nursing and also has cause to be grateful for operational help with limb problems. Hey, we need it from the first day we're born. Then again, having worked and paid tax and insurance all my life I'm allowed a view on it. Bruce made the point about free sources and unlimited demand and that sums up the N.H.S and it's problems in a nutshell. It was instituted for and in a country - still one of the finest and most forward in the world- that could sustain it. It no longer can due to demand exceeding supply. That's the simple part of it. Britain has become a year-long January sale.

The issue is that what we expect the NHS to do is greater than what we pay for. Don't be blindsided by the nonsense in the right wing media. Sure there are timewasters and the like. And there are even foreigners...

But the biggest drain on the system, the big issue, is the complex array of treatments that keep people alive longer. That give kids with cancer a chance. That screen millions of people for diseases and save millions of lives. But all these things were not envisaged when the NHS was established. But they are now expected. And people HOWL when they are told "sorry its not cost effective to keep Ethel alive". Social care, complex long term treatments and the like is the big drain on the NHS.

AT is right in that we need to decide what we want the NHS to actually do, and consequently be prepared to pay for it.

Here's a thought. We invest billions into nuclear weapons that should they ever be used, we're all dead anyway. Scrap those and use that money to pay for Ethel to be kept alive. For me thats a tremendous deal.

[Abdoulaye's Twin]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

That system is one that was actually being implemented via Labour's very ambitious but ultimately flawed NHS IT re-vamp.

There were a lot of issues it threw up. For example such a system relies on everyone being comfortable having their health records centrally.

- They don't have a choice. I'm not advocating an open system, just a central system (properly secured etc) that with your permission any GP can access. I don't have a choice over what data the government hold on me, despite I suspect much of it being non-essential to provide services to me. So why should we allow people to withhold relevant info that is necessary to administer healthcare.

Millions of people aren't and opt out. Also many IT challenges. What happens when systems go down?

- You build redundancy and proper back up systems.

In essence much of this does exist. When you go to the hospital they have some of your health records on their systems (in the past all they had was the referral letter from your GP). There is a form of centralised IT but it hasn't gone as far as it should, but its incredibly complex.

Beyond IT the Tories wanted to have the "go to any GP anywhere" model. But abandoned it because practically its impossible to manage.

It's manageable in other countries.

A GP practice accepts the number of registrations it can support. For example a GP practice in central Manchester may choose to accept local residents and workers IF it can support that. (Though some practices still refuse to accept out of area registrations because of the issue of house visits). However, a totally open and free model means GP's in some areas would be swamped. And remember GP practices are in essence privately run. So you cannot easily manage that supply and demand centrally.

It just means that you either wait for an appointment at x practice, or get in quicker at a different practice if you prefer. GPs are paid for lists of folk that don't go for years on end. The practices could be paid for the work they do rather than having a huge list.

None of it is insurmountable. I'm not trivialising the difficulty of it, but it is possible if you're willing to invest and support it. we should be looking at what works in other countries and mixing that with what works well in the UK. It isn't one thing or another, rather a collection of best practice that balances efficiency with cost and outcomes.

[Abdoulaye's Twin]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

Would that it were all that simple, A.T.. What's the policy on those who can't/wont contribute, let em die? The non-contributers are, and always have been, a fact, way of life. It's very hard to adopt a fair shares for all policy when all aren't prepared to share. Dodgers, lead-swingers and grabbers have, and are ruining the system in many areas of life, this is a fact, and the government's answer is "drop it like a hot cake" privatisation on everything to get problems off their desks. Despite hardly ever having used the N.H.S (certainly never abused it) I have every reason to see its worth. My wife has worked in nursing and also has cause to be grateful for operational help with limb problems. Hey, we need it from the first day we're born. Then again, having worked and paid tax and insurance all my life I'm allowed a view on it. Bruce made the point about free sources and unlimited demand and that sums up the N.H.S and it's problems in a nutshell. It was instituted for and in a country - still one of the finest and most forward in the world- that could sustain it. It no longer can due to demand exceeding supply. That's the simple part of it. Britain has become a year-long January sale.

You misunderstood my wafflings Tango. I wasn't advocating a system where individuals pay. It's a case of paying through taxation what is required to deliver what we want the system to be. Nobody likes to pay tax, but we should be prepared not to punish politicians for raising taxes in order to get what need.

[BWFC_Insane]

Insano, I'd argue that the way we access healthcare is out of date and inefficient. The concept of having a particular GP, or even a particular practice that you go to might have worked decades ago, but we're more mobile and live and work further apart than ever. Proper centralised records, with the ability to go to any GP, anywhere in the country and eligibility verified through a national id card that also functions as drivers license etc etc. There needs to be greater flexibility in where and when you can access GP/nurse services. NHS walk in centres were great and there needs to be more of them. A non partisan rethink is needed and as a nation we need to decide what sort of service we want it to be and be willing to pay for it.

That system is one that was actually being implemented via Labour's very ambitious but ultimately flawed NHS IT re-vamp.

There were a lot of issues it threw up. For example such a system relies on everyone being comfortable having their health records centrally.

- They don't have a choice. I'm not advocating an open system, just a central system (properly secured etc) that with your permission any GP can access. I don't have a choice over what data the government hold on me, despite I suspect much of it being non-essential to provide services to me. So why should we allow people to withhold relevant info that is necessary to administer healthcare.

Millions of people aren't and opt out. Also many IT challenges. What happens when systems go down?

- You build redundancy and proper back up systems.

In essence much of this does exist. When you go to the hospital they have some of your health records on their systems (in the past all they had was the referral letter from your GP). There is a form of centralised IT but it hasn't gone as far as it should, but its incredibly complex.

Beyond IT the Tories wanted to have the "go to any GP anywhere" model. But abandoned it because practically its impossible to manage.

It's manageable in other countries.

A GP practice accepts the number of registrations it can support. For example a GP practice in central Manchester may choose to accept local residents and workers IF it can support that. (Though some practices still refuse to accept out of area registrations because of the issue of house visits). However, a totally open and free model means GP's in some areas would be swamped. And remember GP practices are in essence privately run. So you cannot easily manage that supply and demand centrally.

It just means that you either wait for an appointment at x practice, or get in quicker at a different practice if you prefer. GPs are paid for lists of folk that don't go for years on end. The practices could be paid for the work they do rather than having a huge list.

None of it is insurmountable. I'm not trivialising the difficulty of it, but it is possible if you're willing to invest and support it. we should be looking at what works in other countries and mixing that with what works well in the UK. It isn't one thing or another, rather a collection of best practice that balances efficiency with cost and outcomes.

I don't disagree with what you say, although this isn't really addressing the major challenges facing the NHS. But still.

The patient record choice was as far as I know required by law. I mean the law can be changed of course.

As for systems and redundancy, yes you can to a point, but even the best cloud services in the world go down. And if you're reliant on that system entirely (as opposed to a GP or hospital that has some local records either electronic or paper) you can have major issues....major shitstorms as mistakes happen.

The problem with the open GP approach is simply how complex it is. Your GP has a commitment to offer you emergency appointments to offer some form of out of practice service (home visits or some other such service). They do all this by managing their lists. Ensuring they cover a certain area (and now in some cases a certain demographic within that area - e.g. workers) and carefully managing practice size to population and its health needs. Opening the doors, whilst from a patient POV is brilliant presents a lot of difficulties. What if you suddenly get a surge in demand? But also need to go and visit three elderly patients at home...your intervention may be crucial. And whilst it can all be managed via appointments..how does such a system then deal with emergencies? Of which there are many. Or how does it deal with sudden local health outbreaks that increase demand into the system?

I'm agreeing with the principal, I just know the realities are much more difficult. The NHS is a peculiar beast, but the demands and expectations upon it are greater than most organisations in the world. Having worked with it in the past it does take really being amongst it, to understand those pressures and understand how many obstacles are incredibly difficult to get over. Amazon fail to deliver 10,000 parcels one week and its some bad press and a bit of customer service T&C needed to rectify it. The NHS make a mistake that kills one person (or fail to adequately care for one person through negligence or demand or whatever or a systems issue) and its a full blown meltdown, inquiries, job losses, politicians pontificating and a top down re-organisation to prevent whatever happened (which is never, ever the fault of the government) from happening again.

[jimbo]

One of the key things to remember when talking about general practice is that there isn't one model that fits all practices. Each practice has a unique population with different health needs. One practice may cover an area with huge poverty and have to manage the associated health issues, while one 3 miles up the road might have the majority of a town's university student population. Delivering care in rural settings is extremely challenging due to geography. Currently the funding structure doesn't quite account for these differences.

Opening up GP practices so you can go anywhere wouldn't be appropriate for a whole load of reasons. There's no doubt it would be convenient for the relatively well, 25-50yo working population who visit their GP once in a blue moon, but the majority of GP patients are complex for a number of reasons, where their ability visit every GP in the country for an opinion really wouldn't be beneficial and would undoubtably lead to harm.

[boltonboris]

Is there any proof of the Tories saying that they wish for the NHS to be fully privatised?

I've never heard it. In fact, Tony Blair once said that NHS privatisation would be inevitable, when he came under fire to selling over 20% of it's services off to private business in a 2 year period