The Politics Thread

[BWFC_Insane]

...and here's me living in a rural area with a high proportion of elderly with a GP practice that's rated Outstanding in every single category.
The problems in the NHS are not fundamentally down to economics or demographics but are almost entirely due to a preponderance of piss poor middle and higher management in all areas of the NHS.

Sorry, but that is utter nonsense.

So how come my GP practice is Outstanding in all categories, performing brilliantly, and is fully funded?
Nepotism? Corruption? Gangland money laundering? Or just plain bloody good management of allocated resource?

1) The worst pressures in the NHS aren't on GP practices. Your GP practice isn't having to cope with A&E rises, rise in planned operations or a severe nursing staff shortage.
2) You've answered your own question. Rural practices don't have the same pressures generally that densely populated poor health inner city ones do.

Out of interest who do you think makes the non-hospital commissioning decisions in your area? (Or in other words who are the middle and higher managers in the NHS?)

Let me spell it out in words of one syllable, and I'll try to speak slooooowly...
Where competent middle/higher management is in place the results are outstanding, where piss poor middle/higher management is in place the results are chaos and waste...
The majority of managers in the NHS couldn't run a quiet pub in a silent zone.

Good. So it’s now abundantly clear that you don’t know what you’re talking about. It’s just no fact, no evidence, no understanding, thick skulled, spitting out any old ‘I reckon’ bollocks.

You really are a bit of a tw*t, aren't you?
Can I ask, because I suspect it's true... Do you happen to be an NHS manager in an area that is currently chaos and waste?

No. A while ago I worked for a company that provided a range of services to the NHS. I worked for a few years closely with the NHS. It gave me enough factual insight to know how commissioning decisions were made. Through it's different now.

Perhaps you might like to explain what knowledge you have of NHS management. Starting with, explaining who commissions non hospital services? Who exactly are these managers you are blaming? What roles are we talking?

[TANGODANCER]

The reason it’s hard to recruit GPs in rural areas is because generally there is a GP shortage. And rural areas are less attractive generally for a lot of reasons. Need to travel further. No, or at least less out of hours support. It’s a tougher life for GPs.

You've never watched "All creatures great and small" have you?

[Lost Leopard Spot]

...and here's me living in a rural area with a high proportion of elderly with a GP practice that's rated Outstanding in every single category.
The problems in the NHS are not fundamentally down to economics or demographics but are almost entirely due to a preponderance of piss poor middle and higher management in all areas of the NHS.

Sorry, but that is utter nonsense.

So how come my GP practice is Outstanding in all categories, performing brilliantly, and is fully funded?
Nepotism? Corruption? Gangland money laundering? Or just plain bloody good management of allocated resource?

1) The worst pressures in the NHS aren't on GP practices. Your GP practice isn't having to cope with A&E rises, rise in planned operations or a severe nursing staff shortage.
2) You've answered your own question. Rural practices don't have the same pressures generally that densely populated poor health inner city ones do.

Out of interest who do you think makes the non-hospital commissioning decisions in your area? (Or in other words who are the middle and higher managers in the NHS?)

Let me spell it out in words of one syllable, and I'll try to speak slooooowly...
Where competent middle/higher management is in place the results are outstanding, where piss poor middle/higher management is in place the results are chaos and waste...
The majority of managers in the NHS couldn't run a quiet pub in a silent zone.

Good. So it’s now abundantly clear that you don’t know what you’re talking about. It’s just no fact, no evidence, no understanding, thick skulled, spitting out any old ‘I reckon’ bollocks.

You really are a bit of a tw*t, aren't you?
Can I ask, because I suspect it's true... Do you happen to be an NHS manager in an area that is currently chaos and waste?

No. A while ago I worked for a company that provided a range of services to the NHS. I worked for a few years closely with the NHS. It gave me enough factual insight to know how commissioning decisions were made. Through it's different now.

Perhaps you might like to explain what knowledge you have of NHS management. Starting with, explaining who commissions non hospital services? Who exactly are these managers you are blaming? What roles are we talking?

No, not particularly, I wouldn't like to "explain what knowledge I have of NHS management", at least not sufficiently for your purposes. The reason for that being that, a) it would identify individuals and organisations I have no intention of disclosing to you, or more precisely the internet, because of a plethora of mainly legal, but also ethical, reasons, and b) I can't be arsed to engage with somebody who seems to think there is a single approach to everything, one based on their own experience which dismisses any other perspective.
You can stick your pretty charts and graphs and biased (from a providers perspective) up your arse when it conflicts from a user/customer/client's point of view. But actually, you can't... you are sooooo intent on being the consumer champion you don't actually bother to listen to the consumer: typical higher management.

[Bruce Rioja]

I think I'll just leave this one here. Enjoy

[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.

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..

Article in the newspaper today states that her (Sophie Walker, leader of the Women's Equality Party: the newest political party in the UK) team, comprising three women and a man, are the first team ever to score ZERO points on University Challenge. Zero. Not one fxcking question correctly answered.
Not exactly a great advert for the Women's Equality Party. I'd resign if I were her, but then again, I'd probably have scored more points than she did, and wouldn't have needed to.

[Bruce Rioja]

The stable genius Spunktrumpet's off again.

Now he's after turfing out the 200,000 Salvadorians out that the US took in after the 2001 earthquake and has given them a Sept 19 deadline to sling their hooks.

I guess he has a point though, I mean, just look how they're sucking the lifeblood out of America.

According to the Center for Migration Studies, they represent more than 135,000 households across the country, with a quarter of them home-owners:

88% part of the labour force
10% self-employed
10% married to US citizens

What a 4ucking c*nt he is. Come on America - you're armed to the hilt. It only needs one of you!

[BWFC_Insane]

Meanwhile back at home, another disastrous day for the Tories with a bungled reshuffle and Greening walking. This really is Major govt part two. Falling out with each other and generally bad news after bad news for them.

Where is Blair mk2 though?

[Abdoulaye's Twin]

You want another Blair? Fookin 'ell, you really are insane.

[BWFC_Insane]

You want another Blair? Fookin 'ell, you really are insane.

No. I was just musing, that the Tories are in turmoil. Like the last day's of Major.

But asking rhetorically who will sweep the nation off their feet ala Blair....

[Hoboh]

Meanwhile back at home, another disastrous day for the Tories with a bungled reshuffle and Greening walking. This really is Major govt part two. Falling out with each other and generally bad news after bad news for them.

Where is Blair mk2 though?

Had I been 'reshuffling' the cabinet, mega failure Greening would have been up against the wall!

(Forgot to say after she'd dragged Amber out of the way first.)

[Abdoulaye's Twin]

The only shuffling they need is out of the door. Every last one of the incompetent idiots...

[BWFC_Insane]

Meanwhile back at home, another disastrous day for the Tories with a bungled reshuffle and Greening walking. This really is Major govt part two. Falling out with each other and generally bad news after bad news for them.

Where is Blair mk2 though?

Had I been 'reshuffling' the cabinet, mega failure Greening would have been up against the wall!

(Forgot to say after she'd dragged Amber out of the way first.)

In my world, the first to go would have been Hunt. And by go, I do mean, let him loose and have him hunted (ba dum tish) by a rabid pack of dogs who haven't eaten for weeks.

But she wanted to demote Hunt, he refused and consequently he got promoted. Tory's are in absolute chaos.

[BWFC_Insane]

The BBC have done some good analysis on the problems in the health service.

http://www.bbc.co.uk/news/health-42572110

This summarises the issues well. The cost of caring for an elderly population being the biggest issue. Drops in social care funding impacting the NHS. Reductions in real terms funding.

[Montreal Wanderer]

A picture is worth a thousand words




Worse and more painful when he figured it out.

[TANGODANCER]

^
Brilliant Monty...

[Lost Leopard Spot]

...and here's me living in a rural area with a high proportion of elderly with a GP practice that's rated Outstanding in every single category.
The problems in the NHS are not fundamentally down to economics or demographics but are almost entirely due to a preponderance of piss poor middle and higher management in all areas of the NHS.

Sorry, but that is utter nonsense.

So how come my GP practice is Outstanding in all categories, performing brilliantly, and is fully funded?
Nepotism? Corruption? Gangland money laundering? Or just plain bloody good management of allocated resource?

1) The worst pressures in the NHS aren't on GP practices. Your GP practice isn't having to cope with A&E rises, rise in planned operations or a severe nursing staff shortage.
2) You've answered your own question. Rural practices don't have the same pressures generally that densely populated poor health inner city ones do.

Out of interest who do you think makes the non-hospital commissioning decisions in your area? (Or in other words who are the middle and higher managers in the NHS?)

Let me spell it out in words of one syllable, and I'll try to speak slooooowly...
Where competent middle/higher management is in place the results are outstanding, where piss poor middle/higher management is in place the results are chaos and waste...
The majority of managers in the NHS couldn't run a quiet pub in a silent zone.

Good. So it’s now abundantly clear that you don’t know what you’re talking about. It’s just no fact, no evidence, no understanding, thick skulled, spitting out any old ‘I reckon’ bollocks.

Apropos of which, a highly critical report from the National Audit Office agrees with me today. The headline sentence of the NAO's report on the state of NHS finances says: "Cuts to services will be needed because local efforts to join up care are hampered by weak leadership and put short-term savings before long-term upgrades to the detriment of the NHS"
The chief executive of the hospitals' group NHS Providers backed the report's conclusions: "Extra funding to facilitate better, more convenient and sustainable ways of providing care for patients was being wasted by poor management and used up just keeping the show on the road, and... meant planning for the future was compromised".
Which by implication means that you are accusing the National Audit Office and the chief executive of NHS Providers of "thick skulled spitting out any old bollocks".
I'll also add that the connection between good GP care and efficacy of taking pressure off hospital services was also highlighted.

[BWFC_Insane]

...and here's me living in a rural area with a high proportion of elderly with a GP practice that's rated Outstanding in every single category.
The problems in the NHS are not fundamentally down to economics or demographics but are almost entirely due to a preponderance of piss poor middle and higher management in all areas of the NHS.

Sorry, but that is utter nonsense.

So how come my GP practice is Outstanding in all categories, performing brilliantly, and is fully funded?
Nepotism? Corruption? Gangland money laundering? Or just plain bloody good management of allocated resource?

1) The worst pressures in the NHS aren't on GP practices. Your GP practice isn't having to cope with A&E rises, rise in planned operations or a severe nursing staff shortage.
2) You've answered your own question. Rural practices don't have the same pressures generally that densely populated poor health inner city ones do.

Out of interest who do you think makes the non-hospital commissioning decisions in your area? (Or in other words who are the middle and higher managers in the NHS?)

Let me spell it out in words of one syllable, and I'll try to speak slooooowly...
Where competent middle/higher management is in place the results are outstanding, where piss poor middle/higher management is in place the results are chaos and waste...
The majority of managers in the NHS couldn't run a quiet pub in a silent zone.

Good. So it’s now abundantly clear that you don’t know what you’re talking about. It’s just no fact, no evidence, no understanding, thick skulled, spitting out any old ‘I reckon’ bollocks.

Apropos of which, a highly critical report from the National Audit Office agrees with me today. The headline sentence of the NAO's report on the state of NHS finances says: "Cuts to services will be needed because local efforts to join up care are hampered by weak leadership and put short-term savings before long-term upgrades to the detriment of the NHS"
The chief executive of the hospitals' group NHS Providers backed the report's conclusions: "Extra funding to facilitate better, more convenient and sustainable ways of providing care for patients was being wasted by poor management and used up just keeping the show on the road, and... meant planning for the future was compromised".
Which by implication means that you are accusing the National Audit Office and the chief executive of NHS Providers of "thick skulled spitting out any old bollocks".
I'll also add that the connection between good GP care and efficacy of taking pressure off hospital services was also highlighted.

What is your source? Because the report does not include that sentence. And you've misquoted (or your source has) the CEO of NHS Providers.

The report states that short term money allocated to the NHS to develop local partnerships across health and social care is instead being used to a) bridge short term funding shortfalls b) reduce deficits - it highlights one of the reasons for this being exorbitantly high interest rates the government charges to trusts in deficit.

And the quote from the NHS Providers CEO...

NHS Providers called for long-term decisions to be taken on the funding of health and social care no later than the autumn budget, and again urged the government to respond with urgency.

Chief executive Chris Hopson said: “This report is an emphatic endorsement of many of the concerns we have raised in recent months.… Extra funding to facilitate better, more convenient and sustainable ways of providing care for patients was used up just keeping the show on the road. And some of the short-term measures to raise revenue, such as the raids on capital budgets, meant planning for the future was further compromised.

“We have warned repeatedly that the growing reliance on one-off measures is not a viable long-term approach.”

Oh and lets add a tweet from him on the same day whilst discussing this report.

Those of in the health policy world have never disputed the claim of record NHS funding levels - the key question is whether the increases are suffucient to keep up with NHS demand and cost rises. The evidence clearly shows that, currently, they're not.

[boltonboris]

What do we put the additional "NHS demand and cost rises" down to?

[BWFC_Insane]

What do we put the additional "NHS demand and cost rises" down to?

It isn't a case of what "we put it down to". Its a case of examining the many pieces of evidence on this subject.

1) Ageing population - rising social care issues alongside cuts to social care provision. Who picks up the slack? Hmmm.....

2) Increasing demand - which means more and more treatments provided by the NHS which increases the demand for them.Think of the sheer number of extra treatments even in the last 20/30 years. Remember when Cameron announced his "Cancer treatment fund" to fund rare treatments for some cancers. Think what extra demand that alone put into the system. Yet the fund didn't cover the extra basic pressures on the systems. Like extra beds, doctors and nurses required for those treatments. It may have (almost) been enough to simply cover the medicines themselves.

3) General societal health is more challenging as the years go on. Asthma and diabetes (two basic diseases generally managed in GP practices) are ever increasing. And both put pressures throughout the system. Severe or even moderate asthmatics for example who get the flu often end up in hospital beds. Hospital beds are incredibly expensive.

4) Increase in knowledge. The more you know about diseases, illnesses etc the more it costs to adequately treat them. Think how much time is spent dealing with patients with mental health issues. And think in the past what might have happened instead...also generally think what is acceptable now.

5) General societal pressures and changes. Go to 1955. You take your sick 3 year old to the doctor. They brush you off and tell you they just need fluids and rest. You go home. Turns out your doctor misses something and your sick 3 year old is seriously ill and suffers some misfortune or god forbid dies. You are angry, go and punch your doctor and then cry and suffer. 2018...same scenario...what do you think happens. First thing is your doctor is far less likely to take a risk. Far more likely to send you to A&E if they're concerned. Because if they do miss something, imagine what happens. Public recriminations, media attention, job losses and potentially dates in court and compensation. I'm not saying any of that is good or bad, simply its a part of our life now. And our expectations (even those who politically will critique everything about the NHS) are sky, sky, high.

[TANGODANCER]

5) General societal pressures and changes. Go to 1955. You take your sick 3 year old to the doctor. They brush you off and tell you they just need fluids and rest.

A lot of folk who were actually around in 1955 might take issue with that wild (and totally incorrect) statement.