The idea that boomers are the only ones who worked hard and that's why they're so well off drives me insane. I don't understand why they find reality so difficult to understand. I've had this conversation over and over again with my parents.
I can literally go through my bank statement line by line with them and they still believe that I must be pissing money up the wall to not be able to afford the same lifestyle they had.
With my Dad being end of life every time I meet anyone who knows him there tends to be a conversation about his life and time and time again "he was a hard worker" comes up. I remember on here at one time posting about the kind of life I wished I could have in terms of work and it was basically what he had. I wasn't called a hard worker, I was called lazy and wanting everything handed to me. Told I should be using the couple of hours at night I have when I get home from work to train myself new skills or get a second job.
We do have a problem coming down the line though. My generation, which followed the boomers, thought that if we worked hard we'd be OK same as our parents. By the time we realised differently it was too late. But there's another generation coming up who don't buy in. They have no commitment to their employer because their employer has no commitment to them. Many of them have already written off the hope of owning their own home or any of the other things we are told to work for.
So now they will work for a few months to get some money together and fuck off to another country where the cost of living is far lower. They've basically taken the concept of a gap year and turned it into a way of living. Do the minimum required to get together the funds to go and enjoy life. Can't say I blame them.
The Employee / Employer commitment issue is an interesting one.
On the one hand, I was genuinely astonished about how far some people seemed to be prepared to commute for relatively poorly paid jobs. Relatively lengthy commutes seem commonplace these days, hardly surprising given the costs associated with moving house (stamp duty, conveyancing costs, reports, estate agents fees, removals companies) and I do wonder how much the UK's carbon footprint could be reduced is lengthy commutes were also reduced. Stamp duty fees seem to me to be at usurious levels and are entirely at the governments behest. Lower cost relocation could also affect school runs, another expense and CO2 burden which has, and probably will continue to, be increased by, e.g., local government decisions around closure of schools in the interest of "efficiency", aka cost cutting.
Anyway, I have digressed. The employee / employer commitment issue. Is this a "chicken and egg" situation. What came first, lack of employer commitment leading to the employee thinking "fuck it, what's the point" - or visa versa.
When I was a lad (hard to imagine I know) most of my off duty time was probably spent on booze, cigarettes and girlfriends. We studied for professional qualifications despite all the distractions. Once we had got them, we generally had to look around for a more senior post elsewhere which paid more and was a small step up the ladder. It amuses my wife when we go somewhere for a visit or whatever and I tell her I was interviewed there over 30 years ago.
These days I think many people in a similar position to I was all those years ago still work hard and get the equivalent qualifications (I have no idea what their recreational pursuits are). However, they don't seem quite so keen to explore the unknown in terms of promotion opportunities elsewhere, many seem to expect that they should be upgraded to earn what they would get with a promotion to a more "senior" role without the post having content that would demand a higher grade. Can be tricky with a nationally agreed banding structure with clear job content requirements having been in place for over twenty years.
If the additional pay is not forthcoming, the employee becomes unhappy and can be a disruptive force. If the pay is awarded, people on a similar rate but with the added responsibilities entitling the post to the higher banding can also become unhappy and potentially disruptive.
I don't have any problem with people earning what the role they are fulfilling is worth and have helped people get their posts regraded. Whether the national grading system really is all that fair, I am not convinced.
Just to add to the the productivity conversation……
‘He (McFadden) will say that while Whitehall departments have grown substantially in recent years — increasing by more than 15,000 workers since the end of 2023 — people have not seen improvements to their public services. Four times as many people (civil servants - not front line) are now working in NHS England and the Department of Health and Social Care than in 2010, when waiting times were shortest and patient satisfaction highest.’
Also in the same article
‘Figures show if all NHS trusts and providers were as productive as the top performers the benefit could equate to up to £20 billion.’
Been saying it for years, underperformance is rife and we’re all paying for it (FP - you know what I mean, directly or indirectly). I’m guessing the problem is and always has been, when departments are asked by the treasury where savings can be made, the same people that are probably overpaid and aren’t delivering, cut frontline employees and services instead of themselves ! Yes, we need more investment in certain areas but someone also needs to sort this shit out. Im glad the government are at least going to try.
That sounds like a quote from Lord Carter of Coles, or his product/service Model Hospital.
There are many issues which aren't addressed with some of the studies around this. For example, some Trusts are bearing costs that others aren't. The UHCW PFI was adding approximately 16% to UHCW reference costs. In essence, this would mean that to match average, all other service delivery costs (staff, consumables etc) would have to be below 16% of national average. That is a pretty big ask.
Over time, national initiatives have been attempted. National procurement for one. I certainly will never forget being told I could no longer negotiate my own "deals" and had to use local NHS supplies catalogue. The prices initially looked good until
A) The national supplies overhead costs were added.
B) Delivery of incompatible consumables which we used as a matched combination, rendering them in effect useless - certainly unfit for
purpose.
C) Delivery of a relatively large number of imperfect items, rendering them unfit for purpose if spotted, or worse if the liquid they were used for storing leaked and was lost.
So the intent was to provide lower cost consumables that were value for money and fit for purpose. We ended up with the exact opposite
The road to hell is lined with good intentions.
Achieving standardisation as opposed to variation within a Trust would be a major achievement. However, doctors tend to have "clinical freedom" which can make that difficult. They will all have their own favourite hip prosthesis or knee prosthesis which they will defend. That OK, but if one is significantly more expensive than the other, then give a clinical justification for it - not one based on "its what I trained on" or one based on an ease of kneeling for a particular religion. May be this is fair enough, the vast majority of consultants aren't employed to deliver savings. They are there to provide what they see as the best care for the patient sitting (or lying down) in front of them.
There will be variation between each patients as all people are different, despite some similarities. Perhaps standardisation is impossible.
