Tax hike to pay for social care... not very Tory!

[Count Steer]

First generation makes it, second generation spends it, third generation blows it. Allegedly.

Did some work with a chap who specialised in establishing the true value of companies in order to sell them at the right price. ie including IPR, customer base/relations and that sort of thing.

Typical family businesses last 3 generations. 1st has the drive and skills to build it, 2nd battles along but doesn't quite have whatever mum/dad had. 3rd reduces it to wreckage through incompetence and profligacy and tries to sell whatever's left.

[Count Steer]

Financial help for offspring: most of the time it's just sound economics. Help with a deposit on a house makes perfect sense. Who wants to see their kids lining the pockets of a buy-to-letter and struggling to raise a deposit when they could be buying an asset?

Depends on the offspring too though*. Most people think the sun shines out of their children's orifices when some of them should really have been strangled at birth. (Every you ever met is likely to be someone's golden child who can do no wrong).

*Choose your investments wisely, they can go up or be spaffed on Internet poker/horses/football betting or sex and drugs and rock and roll

[Count Steer]

Depends on the offspring too though*. Most people think the sun shines out of their children's orifices when some of them should really have been strangled at birth. (Every you ever met is likely to be someone's golden child who can do no wrong).

IMHO it's not usually about the kid, it's about the adult using the kid to moan about the chip on their own shoulder - there are no jobs, the police are out out to get us, rich people are shafting us, he can't get a job because of immigrants/government/whatever, the teachers have it in for him, everyone is always picking on him, etc.

Oh, absolutely, it's bound to have a detrimental effect on kids if their parents are always moaning about how everything that's wrong is down to x,y and z people.

[Le_Fromage_Grande]

- there are no jobs, the police are out out to get us, rich people are shafting us, he can't get a job because of immigrants/government/whatever, the teachers have it in for him, everyone is always picking on him, etc.

This was what I thought when I was about 17, but I didn't get in from my parents as I saw very little of either of them from about the age of 7, we lived in the same house but didn't interact much (their choice, their problem), I think I learnt it from the media and the music I liked (which was people making money out of telling people like me how shit their lives were)

Anyway somewhere around that time I read that all of peoples problems were caused by themselves and it was up to that person to deal with those problems, I took this on board and sorted my life out, I'm now sat on my fat arse being paid £1000 a week and posting crap on internet forums.

While not the bit about all peoples problems being caused by themselves is bollocks, how you deal with those problems IS up to you, you can sit on your arse whining and whingeing that someone else should sort out your life for you, or you can get off your arse and get on with life.

[Saga Lout]

The fact is that this £x bn NHI tax increase for social care will not go to the front line any more than the £10bn a year the NHS says it needs to reduce waiting times to acceptable levels in 5 years time would go the front line.

Everyone knows this but they also know that the NHS and social care system has become an insatiable monster where results are completely disconnected from funding, but its status as the No.1 political sacred cow means that this can never change.

The NHI tax increase is simply a political move to shut up the "NHS/care system needs more money" screamers. For now.

The main problem with the NHS stems from the fact that its mantra is "free at the point of use". Get rid of that and it might stand a chance of becoming a first world health service. If you have limited resources then you have to ration them. there are two main ways to do this, you can ration them by queues or you can ration them by price. We (the UK) choose queues, then we complain when the queues get to be too long.

The NHS will stumble from crisis to crisis until we get rid of the idea that it should be free.

[Docca]

You could also ration it by need. A lot of the ails that are treated by the NHS are because we have an NHS. We have a backlog of the worried well and the negligent.

By the time you get the need for genuine direct care, fine. However, 40% of those that require support are for ‘avoidable’ ailments. Investing in the betterment of the wider determinants of health such as school education and workplace wellbeing will go a long way to helping.

Acute care is the only real sustainable part of the NHS and that’s crumbling. It won’t suit this right wing forum to talk about underinvestment in recruitment ( I didn’t say wages) or facilities, but the facts are we have an ageing workforce and were patching this up as best we could with overseas nurses and doctors.

Primary care model needs flipped and that’s happening because the GP landscape at the moment is shocking.

I’m not opposed to paying more tax for care, I’m a socialist. I am worried that we seemed to find billions for the chumocracy deals of recent times and how much of this hike will actually benefit patients and carers in real terms.

[Mr Moofo]

I wholeheartedly agree that there is a severe underinvestment in the NHS, I'm not talking primarily about funding though, I'm talking about a shake up of how it is managed and investing in management capability.

It has got better since things like the Aldar Hay, Bristol and Stafford scandals, but it's still a dinosaur that can't wash it's own face, and it's been that way for decades regardless of which political party has been in No.10.

Spot on :
The NHS may have funding issues - but it is certainly not helped by its own structure and management practices - and it ability to waste money like no other organisation.
270k to recruit a bunch more child execs. Tell you what. Let's just have one fro the whole of the NHS , pay him 500k and make him accountable. Why in god's name does it have to be as fractionated as it is/
For the NHS to warrant more money, they should come up with the deliverables to take the service forward rather then backwards. And get GPs to actually see their "customers".

[Docca]

I wholeheartedly agree that there is a severe underinvestment in the NHS, I'm not talking primarily about funding though, I'm talking about a shake up of how it is managed and investing in management capability.

It has got better since things like the Aldar Hay, Bristol and Stafford scandals, but it's still a dinosaur that can't wash it's own face, and it's been that way for decades regardless of which political party has been in No.10.

Spot on :
The NHS may have funding issues - but it is certainly not helped by its own structure and management practices - and it ability to waste money like no other organisation.
270k to recruit a bunch more child execs. Tell you what. Let's just have one fro the whole of the NHS , pay him 500k and make him accountable. Why in god's name does it have to be as fractionated as it is/
For the NHS to warrant more money, they should come up with the deliverables to take the service forward rather then backwards. And get GPs to actually see their "customers".

Because to think of the NHS as one organisation is naive. It’s a collection of hundreds. It’s a bit easier when you get to Wales and Scotland, but England is a collection of dozens of local authorities, integrated care partnerships, integrated care systems etc etc. So no, it’s nowhere near as simple as you describe. If only.

[Le_Fromage_Grande]

, I’m a champagne socialist.

Corrected for you

[Le_Fromage_Grande]

I wholeheartedly agree that there is a severe underinvestment in the NHS, I'm not talking primarily about funding though, I'm talking about a shake up of how it is managed and investing in management capability.

It has got better since things like the Aldar Hay, Bristol and Stafford scandals, but it's still a dinosaur that can't wash it's own face, and it's been that way for decades regardless of which political party has been in No.10.

Spot on :
The NHS may have funding issues - but it is certainly not helped by its own structure and management practices - and it ability to waste money like no other organisation.
270k to recruit a bunch more child execs. Tell you what. Let's just have one fro the whole of the NHS , pay him 500k and make him accountable. Why in god's name does it have to be as fractionated as it is/
For the NHS to warrant more money, they should come up with the deliverables to take the service forward rather then backwards. And get GPs to actually see their "customers".

Because to think of the NHS as one organisation is naive. It’s a collection of hundreds. It’s a bit easier when you get to Wales and Scotland, but England is a collection of dozens of local authorities, integrated care partnerships, integrated care systems etc etc. So no, it’s nowhere near as simple as you describe. If only.

Only because that's the way it has been organised, it would be far more efficient if it was one organisation

[Docca]

Interesting. How has it been organised? ( apart from ‘badly’) What insights do you have to share?

What would the benefits be against a backdrop of the complex health and care systems that operate currently? What funding models would you prefer to adopt over the current approach ( that I’m sure you’re tired of waxing lyrical about?)

It’s incredible how many people who go through higher education and have more left-leaning politics. Not sure what the correlation could be there, champagne or otherwise.

[slowsider]

, I’m a champagne socialist.

Corrected for you

Levelling-up is an orthodox Tory thing now, isn't it?

[Mussels]

It’s incredible how many people who go through higher education and have more left-leaning politics. Not sure what the correlation could be there, champagne or otherwise.

That bit doesn't need a PHD to work out, it's the same reason children who are sent to Sunday school are more likely to believe in God.

[Le_Fromage_Grande]

Interesting. How has it been organised? ( apart from ‘badly’) What insights do you have to share?

What would the benefits be against a backdrop of the complex health and care systems that operate currently? What funding models would you prefer to adopt over the current approach ( that I’m sure you’re tired of waxing lyrical about?)

It’s incredible how many people who go through higher education and have more left-leaning politics. Not sure what the correlation could be there, champagne or otherwise.

My wife used to be a senior manager at North Middlesex Hospital, that's were my insights come from.

If the purchasing was done nationally you could reap the benefits of mass buying power.
Has the NHS got a single computer system yet?
If GPs were part of the same organisation as hospitals there wouldn't be the funding issue of "who's budget does the treatment come out of"
If the NHS were a single organisation there wouldn't be issued with care when patients need to go from one hospital to another.

That's just off the top of my head, the NHS is a great idea, but it appears the people running it are clueless.

I've possibly got more higher education than you, but it wasn't from the state - it's all technical education.

And what do you do that's socialist, from what I've seen in here you're happy for lorry drivers to get poorly paid so long as you get cheap coffee, not very left wing of you.

[Docca]

My wife used to be a senior manager at North Middlesex Hospital, that's were my insights come from.

If the purchasing was done nationally you could reap the benefits of mass buying power.
Has the NHS got a single computer system yet?
If GPs were part of the same organisation as hospitals there wouldn't be the funding issue of "who's budget does the treatment come out of"
If the NHS were a single organisation there wouldn't be issued with care when patients need to go from one hospital to another.

I’ve no idea what a senior manager is I’m afraid, and I’ve been working in the NHS for a while. I don’t want to bias my views of your comment from my own experience, but anyone with ‘senior’ in their title tends to be anything but.

National procurement is a nice idea, but it is miles from the reality of localised need. A really quick example: impoverished areas tend to need greater social care support ( housing and that type of thing) and the associated health support that goes with it. People in Islington might be pissed if they have to have 50% of the procurement allocation for something they just don’t need. The minute you stop thinking of the NHS as a single organisation, the better. The emergence of integrated health systems will help in this space, particularly when you consider funding is being centrally devolved to them.

Following on from more than one system- the NHS couldn’t sustain a ‘single computer system’ and any thought to the contrary is folly- perhaps a few more technical qualifications would help you understand this? The thought of having surgery, community care, mental health, children’s services etc etc all on a single system is madness from both a usability and reporting perspective.

What we do have no is more and more integrated systems, with more organisations moving away from behemoth installed base garden-walled electronic records systems to more openEHR. The fluidity of health and care demands systems that can cope with chance, which ‘one system’ won’t.

This is a reasonable answer though and won’t fit the ‘NHS is run by bastards’ narrative you seem keen to subscribe to.

That's just off the top of my head, the NHS is a great idea, but it appears the people running it are clueless.

Like that.

I will say, again, that the position in England is worse than elsewhere due to years of competitive commissioning. It can do more to learn from what’s working well.

I've possibly got more higher education than you, but it wasn't from the state - it's all technical education.

I’ve no idea what the state has to do with this and it’s more than likely the neighbourhood squirrel has ‘more higher education’ (sic) than me. The point stands, it would appear the more broadly educated a person is, the greater the likelihood they’ll be left leaning. It’s no fluke; you get to learn how to critique and appraise and then make more informed choices.

And what do you do that's socialist, from what I've seen in here you're happy for lorry drivers to get poorly paid so long as you get cheap coffee, not very left wing of you.

I’m really not happy for lorry drivers to get poorly paid - where have I said that? I even think I stated that the arguement of ‘if they don’t like the pay they can get another job’ ( as is the typical arrow fired at nurses for example) was nonsense.

Here:

This is Twitter, so will get Iccy’s back up straight away, but it’s the Torygraph with an own-goal headline. A bit like suggesting everyone who works at a newspaper needs to be a journalist or everyone who lives at Buckingham Palace needs to be the queen or everyone who works at an airline needs to be a pilot.

Here is a good response from the many who have pointed out to the Telegraph it’s a load of twaddle:

[Mr. Dazzle]

I think a classic mistake people make is to assume the NHS - which is fucking massive let's not forget - is like the company they work for, but, you know, bigger.

It was the same with Brexit wasn't it? "I can negotiate a house sale in 24hrs, therefore a comprehensive international trade deal can't possibly take more than 2 weeks".

My experience of the NHS is that they're organisationally an absolute load of arse, but about 90% of that is down to grumpy secretaries. Not a clue how you'd fix it.

[Saga Lout]

...
My experience of the NHS is that they're organisationally an absolute load of arse, but about 90% of that is down to grumpy secretaries. Not a clue how you'd fix it.

Hire managers who know how to hire friendly secretaries would be a start.

[demographic]

The main working experience Ive had with the NHS was OK, although I wasn't blown away by the company that did the maintenance/building contracts. Integral? Initial? Something like that. It was a while ago.
They didn't seem blessed by an overabundance of competence and the company seemed to have been setup to skim a bit off the top.

Oh and Amec built a new hospital and I worked on that. They werent the best either.

[cheb]

The first thing I'd address in the NHS is the culture of lateness and poor time management. Yes. you're busy, but your time is no more valuable than mine.

If I've turned up early for the first appointment of the day I don't expect to be seen two hours late. Especially not as that means I miss my connections back to the island and have to take another day off work. I'm self employed, no work = no pay.

[Mr. Dazzle]

Every time I've been to an NHS appointment in recent years I've been the first patient of the day. They still manage to run late

I suspect its cultural more than anything. Being busy and late "is OK" so everyone just expects it.