27 Apr 20
@wolfgang59 saidDo you think this could actually happen?
With the threat of negative interest rates they had better spend it soon!
27 Apr 20
@divegeester saidJapan, Germany and one of the Scandinavian countries have all stepped
Do you think this could actually happen?
their toes into the uncharted waters of negative interest rates. The
European Central Bank too. The US came close last month and Trump
is a fan. It's a difficult concept that I've read conflicting forecasts about.
It would be fun to take out an interest only mortgage and get paid for doing so!
27 Apr 20
@divegeester saidSomething we can agree on?
It’s time for the Tory government to wrestle the NHS away from the political grip of labour and make an irreversible statutory mandate to increase NHS funding by a XX% every year.
Although if I had suggested it I would have been called a Utopian Idealist!
I think any such legislation would have to be surrounded by so many caveats
that it would effectively be worthless, but I'd be very happy to be proved wrong.
What XX% do you have in mind?
+2% adjusted for inflation?
@wolfgang59 saidYou wouldn’t have been by me; I hold quite firm socialist views on public heath, education, infrastructure and utility ownership, social care etc.
Something we can agree on?
Although if I had suggested it I would have been called a Utopian Idealist!
I think any such legislation would have to be surrounded by so many caveats
that it would effectively be worthless, but I'd be very happy to be proved wrong.
What XX% do you have in mind?
+2% adjusted for inflation?
In answer to the bottom line, I’m not trying to dodge but I don’t know. The NHS is riddled with poor “management process” run too often by poor managers.
Procurement needs a complete bottom up overhaul and should be completely (or at least mostly) centralised via the NHS Supply Chain enterprise. Suppliers need to be made to pitch for a three year access to improve cost control and be levied punitive charges for shortages. Preferred Pharma companies who supply the nhs should be made to do so from within the uk and drugs used here here should be made he as much as possible.
Also I feel the country would benefit from lots more huge regional centres of excellence for high volume clinical and surgical procedures the funding of which can be supported by the suppliers who have market access.
Lots needs to change.
27 Apr 20
2 edits
@divegeester saidThat has to happen. The rising cost in advances in the treatment of cancer, the need for extra hospitals for the growing population, the rising number of young people with obesity who will need treatment for type 2 diabetes, hypertension and high cholesterol earlier on in life, rise in costs of mental health services for children and adolescents and so on .... the NHS is a bottomless pit.
It’s time for the Tory government to wrestle the NHS away from the political grip of labour and make an irreversible statutory mandate to increase NHS funding by a XX% every year.
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27 Apr 20
@wolfgang59 saidOnly if it was in an account with a flexible interest rate. Read about that in Germany, apparently it was implemented so lenders would give out loans during the pandemic. Of course, then a bank decided to open a new savings account with the negative interest rate effectively charging a fee if you wanted to save.
With the threat of negative interest rates they had better spend it soon!
@divegeester saidThe NHS needs a massive cash injection as well as year on year increase. It also needs an honest look at where the money actually goes.
It’s time for the Tory government to wrestle the NHS away from the political grip of labour and make an irreversible statutory mandate to increase NHS funding by a XX% every year.
There has been a twenty fold increase in NHS administrative and managerial roles since the 1980s. It was said that an internal market place would increase efficiency. In reality the creation of commissioning Trusts and separate provider Trusts all with ridiculous numbers of managers and administrators and highly paid Directors on their boards is obscenely expensive. Every new government announces a cash injection but in reality they just announce what was needed to cover the cost of the pensions for this army of parasites. It was a Tory government that started that new structure. New Labour and Tories maintained it for decades.
When I was working fear of putting in recurrent new money meant time limit funding of waiting list initiatives and other such projects. So the funding stream could be stopped once completed. Of course the first spend was a new project manager!
There are more vacant doctor's posts than ever. Loads of nurses were getting out young when I retired and I see no reason why being abandoned to deal with COVID with no PPE will reverse that trend. It is no secret that running down stocks of PPE and ignoring warnings issued after SARS was a part of the year on year 'cost improvements' that were going on. In my final year we were actually told by management that we couldn't call 'cost improvements' cuts!
We need the 50000 doctors required to have as many per head of population as France. We need respectable pay for nurses and more qualified staff otside of the ward office. We need to stop acting like Trusts and clinicians are failing when they have been failed by the underfunding of the same government that sanctimoniously announce they will investigate when things go wrong as if it were nothing to do with their policy.
Sadly we also need to take a close look at what happens to the charity of heroes like Captain Tom. I was placed in an obstetric unit as a student in the 1980s. The overworked staff raised money for a new scan in their own time. It was decided that since they were so effective at raising money their budget could be reduced by an equivalent amount the following year so now they had to raise that amount every year just to break even. That was the start of the trend towards relying on charity to fill the gaps left by cuts. Hence we see so many campaigns for cancer research, heart research, Macmillan nurses etc.
I would hate it if Captain Tom's money was used to allow a budget to be cut, but watch this space!
27 Apr 20
In the 90s my ex was on the board of an NHS trust, the bureaucracy was
unbelievable, one of the worst things was VAT. It was so complex. They
had half the finance department managing it PLUS an external consultant
who charged them 10% on any savings he made for them. One year he
got close to £500,000. So that was government money for reducing the
tax that the government paid itself! Crazy.
27 Apr 20
@wolfgang59 saidUnbelievable! Meaning so great or extreme as to be difficult to believe; extraordinary.
In the 90s my ex was on the board of an NHS trust, the bureaucracy was
unbelievable, one of the worst things was VAT. It was so complex. They
had half the finance department managing it PLUS an external consultant
who charged them 10% on any savings he made for them. One year he
got close to £500,000. So that was government money for reducing the
tax that the government paid itself! Crazy.
-VR
27 Apr 20
@wolfgang59 saidIt's crazy and after doing my 30 years as a clinician I can tell you how demoralising it feels to be part of it. If they try and save money they do it by paying even more to management to study the problem and then conclude they need to cut the clinical budget. When I started there were State Enrolled Nurses who usually wore green and were very hands on and State Registered Nurses who were still on the ward more than they were in the office. They got rid of the Enrolled Nurses and replaced them with low paid minimally trained Health Care Assistants and cut the now Registered General Nurses to the point that there are rarely enough numbers to get them out on the ward from the office. They spend their time permanently meeting managements demand for spurious data so that they can further their career by producing the right graph to make the Trust look good. There was a public enquiry after excessive deaths in the Emergency Room in Stafford. The board were found to be collecting such skewed data that the performance appeared good despite long periods of time with no trained staff in the emergency room at all. People don't realise just how far things have gone in the health service!
In the 90s my ex was on the board of an NHS trust, the bureaucracy was
unbelievable, one of the worst things was VAT. It was so complex. They
had half the finance department managing it PLUS an external consultant
who charged them 10% on any savings he made for them. One year he
got close to £500,000. So that was government money for reducing the
tax that the government paid itself! Crazy.
@drewnogal saidCaptain Tom, is 100 years of age today! He’s getting a fly over and will now been made an honorary colonel ❤️
100 tomorrow and over £8,000,000 raised for the NHS! We thank you 😇
He received 125,000 birthday cards and has raised almost
£30, 000,000. The fund closes at midnight tonight.
https://www.standard.co.uk/news/uk/captain-tom-moore-sent-125000-cards-for-his-100th-birthday-a4425561.html
30 Apr 20
@drewnogal saidI hope he enjoys his day, what a legacy.
Captain Tom, is 100 years of age today! He’s getting a fly over and will now been made an honorary colonel ❤️
He received 125,000 birthday cards and has raised almost
£30, 000,000. The fund closes at midnight tonight.
https://www.standard.co.uk/news/uk/captain-tom-moore-sent-125000-cards-for-his-100th-birthday-a4425561.html
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30 Apr 20
@divegeester saidMade great viewing this morning.
I hope he enjoys his day, what a legacy.
What a hero.