The Politics Thread

[jimbo]

To be fair the current health secretary co-wrote a book in 2005 advocating switching to an insurance based healthcare system.....

For what it's worth though, I don't buy it. People love the NHS. It would be a seriously risky political move for any party to willingly oversee the end of it. The only worry is that a party might be comfortable with recurrent high profile examples of how it's not fit for purpose in order to try to sway the view of the public that an alernative may be better.....

[BWFC_Insane]

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

I mean apart from all the Tories who have talked about it, then rowed back when the realised they were either in office, or not as popular as they thought....

As for Blair, your description is not entirely accurate. He didn't sell off services. He a) established an internal market and b) introduced Independent Sector Treatment Centres - which whilst expensive did alleviate pressures in the system.

The Any qualified provider stuff (which I assume you refer to) came in under Brown, and Labour did actually row back on these plans just before the election. Cameron and Osborne of course accelerated them at a pace.

I fundamentally disagree with what Blair and (more patently the Brown) administration did to the NHS later in their time, but on the counter you have to acknowledge the huge improvements they brought to the NHS during their time off the back of huge amounts of funding.

[jimbo]

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

I mean apart from all the Tories who have talked about it, then rowed back when the realised they were either in office, or not as popular as they thought....

As for Blair, your description is not entirely accurate. He didn't sell off services. He a) established an internal market and b) introduced Independent Sector Treatment Centres - which whilst expensive did alleviate pressures in the system.

The Any qualified provider stuff (which I assume you refer to) came in under Brown, and Labour did actually row back on these plans just before the election. Cameron and Osborne of course accelerated them at a pace.

I fundamentally disagree with what Blair and (more patently the Brown) administration did to the NHS later in their time, but on the counter you have to acknowledge the huge improvements(damage) they brought to the NHS during their time off the back of huge amounts of PFIfunding.

I've edited the last line to leave it open to interpretation depending on your viewpoint. No doubt investment in NHS infrastructure is great, but it's also bankrupting many trusts around the country.

[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.

[BWFC_Insane]

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

I mean apart from all the Tories who have talked about it, then rowed back when the realised they were either in office, or not as popular as they thought....

As for Blair, your description is not entirely accurate. He didn't sell off services. He a) established an internal market and b) introduced Independent Sector Treatment Centres - which whilst expensive did alleviate pressures in the system.

The Any qualified provider stuff (which I assume you refer to) came in under Brown, and Labour did actually row back on these plans just before the election. Cameron and Osborne of course accelerated them at a pace.

I fundamentally disagree with what Blair and (more patently the Brown) administration did to the NHS later in their time, but on the counter you have to acknowledge the huge improvements(damage) they brought to the NHS during their time off the back of huge amounts of PFIfunding.

I've edited the last line to leave it open to interpretation depending on your viewpoint. No doubt investment in NHS infrastructure is great, but it's also bankrupting many trusts around the country.

Absolutely. PFI was a disaster. But even when it was common knowledge, Cameron and Osborne persisted with it.

But its a separate issue to the huge funding spike that improved NHS performance from the mess Blair inherited.

[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.

[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?

[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?)

[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.

[Lost Leopard Spot]

I'll also quote jimbo above..."delivering care in rural settings is extremely challenging..."

[jimbo]

And I'll happily draw on my own experience and stand by my claim.

[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.

[boltonboris]

So Rural GP practices perform better because there's not as many people in Rural areas.. Fair enough, if you've actually bothered to check if the number of GP's per capita in rural areas is any different to GP's per capita in big city areas

I haven't checked by the way, but I'm interested to see just how different those stats are

[jimbo]

All rural areas are different, but the fact that the government are lining up £20000 golden handshakes to gp's who move to specific rural areas where it's typically harder to recruit is a pretty fair reflection of the current recruitment problem and GP shortage that they have on the whole.

[boltonboris]

What's the recruitment problem down to? lack of skilled workers? Poor pay? Reputation of the organisation?

I think it's a mix of the latter 2 which needs addressing - You can only address pay issues through more funding, but will the hospitals trusts actually pass on extra funding to staff?

Reputation of the organisation leads to lack of confidence over job security. There are plenty of people withing the trusts and government who are to blame for that

[BWFC_Insane]

So Rural GP practices perform better because there's not as many people in Rural areas.. Fair enough, if you've actually bothered to check if the number of GP's per capita in rural areas is any different to GP's per capita in big city areas

I haven't checked by the way, but I'm interested to see just how different those stats are

Eh? It depends. Rural and deprived Welsh valleys for example offer a different challenge to rural Cheshire.

GP practices range in how good they are. And some have greater pressures than others.

But the point is that the pressure points in the NHS generally aren’t on general practice.

[BWFC_Insane]

What's the recruitment problem down to? lack of skilled workers? Poor pay? Reputation of the organisation?

I think it's a mix of the latter 2 which needs addressing - You can only address pay issues through more funding, but will the hospitals trusts actually pass on extra funding to staff?

Reputation of the organisation leads to lack of confidence over job security. There are plenty of people withing the trusts and government who are to blame for that

Can I ask what any of this has to do with GP recruitment?

[BWFC_Insane]

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.

[jimbo]

There's multiple reasons for the lack of GPs. There's a shortage of doctors overall in this country, so when one speciality becomes less appealing less people will choose it. Then when there's a lack of GP's, there's a load of jobs to apply for and not that much competition. As a result, people tend to choose the high performing practices in nice areas to work in, leaving those poorly performing practices understaffed year after year without the funding from the government to offer more competitive pay to attract people.

As for why general practice has become less popular - pay for partners has fallen dramatically, which while I'm actually in favour of, has obviously made it less attractive to some. Long gone are the days of the partners earning huge money from practice profits.

Alongside the fall in pay is my personal bugbear - rising indemnity costs. A full time GP pays around £10k per year in insurance as the popularity of no win, no fee cases has exploded. Hospital doctors are covered by the trust and don't have to take out personal cover.

The workload has also got much greater. Patients are more complex, the burden of admin and paper work has exploded. A 4 hour session seeing patients will typically generate about 2 hours of paperwork, all of which has to be done either on your day off, by getting in early, or staying late. This makes locum work more attractive, where you can turn up and see patients and go home. Due to the shortage of GPs, there's no shortage of locum work available and it pays better, however there are the general risks of being self employed.

Despite all the above, it's still a great job and a genuine privelage to be able to get to know and help people in a way that can't be done in hospital medicine. There's just not as many see it the same way as me.

[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 nice person, 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?