Current Affairs

[Kendhni]

I've thought for a long time that the NHS is too important top be a political football. It has been plagued by one reorganisation after another. The parties should get together and agree a 25 year plan that can only be altered by a cross party vote. And it should be funded, as some other countries are, by a levy separate from other taxes and ring fenced.

It would suggest that it is more complex than that. It is not good enough to ring fence the money as a lump sum, but it needs to be ring fenced at a more granular level including departmental and salaries - otherwise we end up with a government within a government answerable to itself ensuring that it spends budgets for fear of getting less in the subsequent financial year (one of the worst traits of the public sector).

[towny44]

I honestly think most would pay more tax for our NHS if it was ring fenced for that purpose, however we don’t seem to have any Government which has been prepared to put it to the people for fear of losing votes at the election.

I am not a fan of ring fences taxation, You have to trust the govt, whichever flavour, to ensure they spend the money wisely.

[Kendhni]

From what we hear on the daily briefings the Government sound pretty steadfast in meeting the 5 principles before any relaxation of lockdowns…that being said my definition of transparencies probably differs from that of what the Government want us to know so the source of your information may well be right.

That is my fear, there seems to be some play towards making the criteria fit reality instead of reality fit the criteria - I hope that is not the case.

I’m sure we all just want to get through this one way or another the inquiry can come latter.

I don't think this has been well handled by the government. However what benefit is there to expensive inquiries costing millions .... millions that could have gone to the health service. You know that all the key players will already be identifying emails and modifying timelines to cover their backs.

As I often say to my FIL, a long retired man who seems to think that everything should have an inquiry ... stop wasting my money on your past, better to spend it on the future.

[david63]

Before we start deciding on how much funding the NHS requires there needs to be a fundamental overhaul of how the NHS is managed because from the little that I have seen it is its own worst enemy when it comes to wasting money with one of the main problems being that it is too big to manage - especially by "mangers" steeped in NHS traditions.

The first thing that needs to happen is to get away from being target focused and get back to being patient focused and then get away from a "one size fits all" attitude imposed from the top down and start looking at the problems from the ground up.

And do we need so many "administrators" wandering hospital corridors all day?

[Mervyn and Trish]

I've thought for a long time that the NHS is too important top be a political football. It has been plagued by one reorganisation after another. The parties should get together and agree a 25 year plan that can only be altered by a cross party vote. And it should be funded, as some other countries are, by a levy separate from other taxes and ring fenced.

It would suggest that it is more complex than that. It is not good enough to ring fence the money as a lump sum, but it needs to be ring fenced at a more granular level including departmental and salaries - otherwise we end up with a government within a government answerable to itself ensuring that it spends budgets for fear of getting less in the subsequent financial year (one of the worst traits of the public sector).

I agree largely with the last bit. There is a lot that is good about the public sector - no shareholders to pay out to for example - but It was bonkers when I worked in it that there was a scramble at the end of the financial year to spend rather than lose money. Over spending managers got bailed out by savings made by prudent ones, so the latter responded by trying not to have any left over for the bail out.

I'd suggest it doesn't need to be right down to department level - that is too close to the micro-management of the last Labour governments. And we don't need the number of separate organisations with duplicated back room functions.

I'd go back to the days of local health authorities to organise primary care and general hospitals for the benefit of their local populations and give those HAs an annual budget which, if not spent, they could save for future years. I'd just add to that maybe regional centres of excellence for things like cancer, major trauma, coronary care etc.

[Mervyn and Trish]

The first thing that needs to happen is to get away from being target focused and get back to being patient focused and then get away from a "one size fits all" attitude imposed from the top down and start looking at the problems from the ground up.

And do we need so many "administrators" wandering hospital corridors all day?

I think some of the latter are a direct result of the former. If you have beans to count you need bean counters.

However, some of the latter are valuable. There are admin tasks to be done even in the most efficient organisation. And it makes no sense for highly trained medical staff to be doing them. They need to be focussed, as you say, on the patients, and they need admin support. The question is how much? Simplify the structure as in my post #2780 above and you immediately reduce the number of admin posts needed. Less beans to count. Less bean counters.

[towny44]

I've thought for a long time that the NHS is too important top be a political football. It has been plagued by one reorganisation after another. The parties should get together and agree a 25 year plan that can only be altered by a cross party vote. And it should be funded, as some other countries are, by a levy separate from other taxes and ring fenced.

It would suggest that it is more complex than that. It is not good enough to ring fence the money as a lump sum, but it needs to be ring fenced at a more granular level including departmental and salaries - otherwise we end up with a government within a government answerable to itself ensuring that it spends budgets for fear of getting less in the subsequent financial year (one of the worst traits of the public sector).

The first thing that needs doing is to bring budgeting back under a more centralised structure, there are far too many instances of decisions being made at local level, without taking account of the impact that would have on other depts. We have a wonderful regional office building which is now being sold at a massive loss as various depts have withdrawn, making it no longer viable. Either the original build was badly costed, or the gradual transfer of services to local NPOs did not take account of the resultant effect on its viability.
This sort of thing must be replicated in hundreds of local authorities nationwide, and along with lots of badly costed PFIs is a major stumbling block to sorting out a fair national cost of services.

[Onelife]

I honestly think most would pay more tax for our NHS if it was ring fenced for that purpose, however we don’t seem to have any Government which has been prepared to put it to the people for fear of losing votes at the election.

I am not a fan of ring fences taxation, You have to trust the govt, whichever flavour, to ensure they spend the money wisely.

Hi John,

We do indeed have to trust the government to spend money wisely and it could also be said that nobody willingly pays more tax than they have to. I believe a ring-fenced tax specifically for the NHS would be an easier pill to swallow by the general tax payer as opposed to a squirrel tax that can be buried away in the guise of benefiting the NHS.

I don’t know enough about how ring fencing would work for other services but a tax that is paid willingly will leave the tax payer thinking the money is well spent... me thinks.

[Manoverboard]

We could throw any amount of money at the NHS but under the present system it would never be enough.

[Onelife]

Before we start deciding on how much funding the NHS requires there needs to be a fundamental overhaul of how the NHS is managed because from the little that I have seen it is its own worst enemy when it comes to wasting money with one of the main problems being that it is too big to manage - especially by "mangers" steeped in NHS traditions.

The first thing that needs to happen is to get away from being target focused and get back to being patient focused and then get away from a "one size fits all" attitude imposed from the top down and start looking at the problems from the ground up.

And do we need so many "administrators" wandering hospital corridors all day?

Some interesting posts most of which you could take snippets from and say yes, I agree, but David’s post seems to encapsulate the fundamental problem of how the NHS is where it is now….perhaps it has got to big to manage. Good managers manage bad managers only cause more pain…my wife thinks there are quite a few freeloader mangers in the NHS that would benefit from a long unpaid holiday. She also thinks there is far too much in house recruitment which retains the good and in a lot of cases the bad of work practices.

[Gill W]

Boris came back and talked tough about lockdown - that was good, However the latest news coming from the government is that they are now manipulating the key criteria to make it look like they have been met so that they can release the lockdown. If that is true then I fear this government has learned little from its early mistakes.

I've noticed that the some of the 'five tests' have been reworded.

e.g.

'Confident that any adjustments to the current measures will not risk a second peak of infections'

has now become

'Confident that any adjustments to the current measures will not risk a second peak of infections that overwhelms the NHS'

[towny44]

Boris came back and talked tough about lockdown - that was good, However the latest news coming from the government is that they are now manipulating the key criteria to make it look like they have been met so that they can release the lockdown. If that is true then I fear this government has learned little from its early mistakes.

I've noticed that the some of the 'five tests' have been reworded.

e.g.

'Confident that any adjustments to the current measures will not risk a second peak of infections'

has now become

'Confident that any adjustments to the current measures will not risk a second peak of infections that overwhelms the NHS'

Since we can assume the first wording was meant to avoid a peak overwhelming the NHS, I think the 2nd version emphasises that point more firmly.

[Kendhni]

I've thought for a long time that the NHS is too important top be a political football. It has been plagued by one reorganisation after another. The parties should get together and agree a 25 year plan that can only be altered by a cross party vote. And it should be funded, as some other countries are, by a levy separate from other taxes and ring fenced.

It would suggest that it is more complex than that. It is not good enough to ring fence the money as a lump sum, but it needs to be ring fenced at a more granular level including departmental and salaries - otherwise we end up with a government within a government answerable to itself ensuring that it spends budgets for fear of getting less in the subsequent financial year (one of the worst traits of the public sector).

The first thing that needs doing is to bring budgeting back under a more centralised structure, there are far too many instances of decisions being made at local level, without taking account of the impact that would have on other depts. We have a wonderful regional office building which is now being sold at a massive loss as various depts have withdrawn, making it no longer viable. Either the original build was badly costed, or the gradual transfer of services to local NPOs did not take account of the resultant effect on its viability.
This sort of thing must be replicated in hundreds of local authorities nationwide, and along with lots of badly costed PFIs is a major stumbling block to sorting out a fair national cost of services.

I think whoever can come up with an answer on how to make the NHS better and more cost effective would be a millionaire overnight.

[Kendhni]

Boris came back and talked tough about lockdown - that was good, However the latest news coming from the government is that they are now manipulating the key criteria to make it look like they have been met so that they can release the lockdown. If that is true then I fear this government has learned little from its early mistakes.

I've noticed that the some of the 'five tests' have been reworded.

e.g.

'Confident that any adjustments to the current measures will not risk a second peak of infections'

has now become

'Confident that any adjustments to the current measures will not risk a second peak of infections that overwhelms the NHS'

I read that and thought 'Oh dear' - that was not the test - exactly what I was talking about.
We are talking about a balance between people's lives and livelihoods - err on the side of caution or the lives lost so far will have taught us nothing.

[Mervyn and Trish]

Interesting new numbers today. The additional all settings deaths data show the number is, as expected, higher than previously confirmed. Which is a tragedy.

But on another front we now have a comparison with other countries calculated per million of the population, which takes out a significant variable. That shows the US is not the baddie it has been painted. And in Europe the worst by a big margin is Belgium. On that analysis we are right in the pack with Italy, France and Spain. And of those it is not clear whether Spain is including care home deaths as most now are.

So maybe the politicians can stop the speculation on how badly we've done and start concentrating on moving forward constructively and positively.

[Manoverboard]

The change of wording doesn't trouble me at all, the position changes regularly and so thereforee will the wording.

Sorry Ken but to critisice any such change is, for me, on a par with nitpicking rather than being informed.

[oldbluefox]

I wonder what those who have been agitating for an early release from lockdown have to say in the face of news that Germany is now suffering a second wave. Looks like they have all moved on to peddle their pessimism elsewhere. Would they be too proud to admit that maybe, in this case, Germany was wrong and we may be dealing with it better than they thought.

[Onelife]

I wonder what those who have been agitating for an early release from lockdown have to say in the face of news that Germany is now suffering a second wave. Looks like they have all moved on to peddle their pessimism elsewhere. Would they be too proud to admit that maybe, in this case, Germany was wrong and we may be dealing with it better than they thought.

Hi foxy… I’ve been keeping my eye on this story and as you say it is a sharp reminder that relaxing lockdown will see us back to square one in no time at all…perhaps it is a good thing that we are two weeks behind some other countries as it allows us to see what awaits us if our Government caves in to media pressure.

We are in a war zone situation and I can’t for a foreseeable future see how any of the five conditions can be lifted.
I still maintain the much-vaunted test and trace system won’t work until such time that we can get infections down in the hundreds…. I will of course be happy if I am wrong.

I think without symptom reducing medication or please gawd a vaccine we will soon be in a situation where, gawd forbid economic necessity forces the Government to ease lockdown but then “behind closed doors” have to calculate what will be an acceptable weekly death rate until such time that a vaccine can be found.

Please tell me I’m over thinking this

[Frank Manning]

Please tell me I’m over thinking this
[/quote]

We are all overthinking it. Let's face it we are quite powerless, and thinking and chuntering about it is all we can do. Dont worry and try to avoid too much mainstream news is my mantra. They are revelling in doomsday reports anyway.

[Kendhni]

The change of wording doesn't trouble me at all, the position changes regularly and so thereforee will the wording.

Sorry Ken but to critisice any such change is, for me, on a par with nitpicking rather than being informed.

I guess I just expect the government to abide by its own statements and comments and not to unnecessarily back pedal to make them fit political posturing and manipulation. Maybe it is because I, and other members of my family, are/could be directly affected by this means I expect higher standards of honesty at the minute and for the government to keep its word.

[Manoverboard]

The change of wording doesn't trouble me at all, the position changes regularly and so thereforee will the wording.

Sorry Ken but to critisice any such change is, for me, on a par with nitpicking rather than being informed.

I guess I just expect the government to abide by its own statements and comments and not to unnecessarily back pedal to make them fit political posturing and manipulation. Maybe it is because I, and other members of my family, are/could be directly affected by this means I expect higher standards of honesty at the minute and for the government to keep its word.

Fair enough but I do think that if you or I were a Government Minister we would also need to manipulate the details along the way during what is after all a brand new experience for most of them.

[Kendhni]

We are in a war zone situation and I can’t for a foreseeable future see how any of the five conditions can be lifted.

I like the comparison with a war zone ... and the biggest ally the enemy has is human stupidity.
I agree with you about the 5 conditions, the government has to stand by those conditions and not relax them, otherwise, as you said, other countries have shown things will probably get much worse - which could mean an even longer period of lockdown in a few months time (assuming that the brakes can be put back on).

The juggling match at the minute is how many people is the country willing to sacrifice in order to move to our NEW normality. Lives vs livelihoods?

Please tell me I’m over thinking this

I would say 'no'. These are unprecedented times and therefore we should err on the side of caution.

[Kendhni]

The change of wording doesn't trouble me at all, the position changes regularly and so thereforee will the wording.

Sorry Ken but to critisice any such change is, for me, on a par with nitpicking rather than being informed.

I guess I just expect the government to abide by its own statements and comments and not to unnecessarily back pedal to make them fit political posturing and manipulation. Maybe it is because I, and other members of my family, are/could be directly affected by this means I expect higher standards of honesty at the minute and for the government to keep its word.

Fair enough but I do think that if you or I were a Government Minister we would also need to manipulate the details along the way during what is after all a brand new experience for most of them.

I don't disagree but, as I said to Onelife, the juggling match is lives vs livelihoods - get that wrong and history will frown on those responsible.

I hope our government is learning from what is happening elsewhere.

[Gill W]

The change of wording doesn't trouble me at all, the position changes regularly and so thereforee will the wording.

Sorry Ken but to critisice any such change is, for me, on a par with nitpicking rather than being informed.

I guess I just expect the government to abide by its own statements and comments and not to unnecessarily back pedal to make them fit political posturing and manipulation. Maybe it is because I, and other members of my family, are/could be directly affected by this means I expect higher standards of honesty at the minute and for the government to keep its word.

What I took from the rewording of the ‘test’ that I mentioned (a second peak not overwhelming the NHS) was that any second peak at the level of the first peak would be acceptable, as the NHS was not overwhelmed this time.

When you consider how many people have lost their lives in this wave, it’s very daunting to consider that this is likely to happen again in any second wave.

[Onelife]

The change of wording doesn't trouble me at all, the position changes regularly and so thereforee will the wording.

Sorry Ken but to critisice any such change is, for me, on a par with nitpicking rather than being informed.

I guess I just expect the government to abide by its own statements and comments and not to unnecessarily back pedal to make them fit political posturing and manipulation. Maybe it is because I, and other members of my family, are/could be directly affected by this means I expect higher standards of honesty at the minute and for the government to keep its word.

Fair enough but I do think that if you or I were a Government Minister we would also need to manipulate the details along the way during what is after all a brand new experience for most of them.

There is truth in what you say Mob but to manipulate generraly involes covering up mistakes and there is no doubt in my mind lives could have been saved had we not started off on the wrong foot of herd immunity......ironically we may well have to revert back to controled herd immunity if we can't come up with a vaccine in the not to distant future.

What was Hospitals/Government thinking when they allowed infected nursing home patients back into their nursing homes