Do you want to discuss boring politics? (24 Viewers)

MalcSB · 2025-03-09T10:11:56+0000

shmmeee said:
Number of people in this thread apoplectic if their tax goes up £5/mo, desperately begging to pay £500/mo extra in healthcare costs.

Where are people begging to pay £500 extra in healthcare costs? The discussion started with a poster describing a scheme ( in Germany? CBA to go through pages of posts to find it) where employERS were paying the equivalent of £7 per employee for private health insurance.

People are paying for a state funded health system which isn’t delivering for many people. The costs of the internal market must be phenomenal, I’m not entirely sure what it has achieved in reality. Other than creating a whole load of bureaucracy at enormous cost.

MalcSB · 2025-03-09T10:19:01+0000

fernandopartridge said:
Social care is paid for by local authorities not the NHS

Social care for some is paid for by local authorities not the NHS.

MalcSB · 2025-03-09T10:28:11+0000

shmmeee said:
The health risks!

Nikocado Avocado - Wikipedia

en.m.wikipedia.org

I found those “Man vs Food“ type programmes quite distasteful but for some reason my wife found them fascinating in a morbid sort of way.

I did say semi professional - would mitigate health risks.

MalcSB · 2025-03-09T10:29:50+0000

Grendel said:
It is true and I’ve never understood privatising the commanding heights. You can’t have taste the difference gas.

All utilities should be state owned and everyone lays the same

Our railway network was destroyed by Beaverbrook and should be a tax funded public transport system

Wasnt it Beeching?

Grendel · 2025-03-09T10:31:47+0000

MalcSB said:
Wasnt it Beeching?

Sorry don’t know why it went to that

Brighton Sky Blue · 2025-03-09T10:39:36+0000

Was in Lesta on Friday and didn’t realise they had free buses doing a circular route around the city.

Captain Dart · 2025-03-09T10:50:11+0000

MalcSB said:
Wasnt it Beeching?

It was. He canned the uneconomic lines and we embarked on building a comprehensive road network.

Beaverbrook was a newspaper proprieter who as Air Minister streamlined warplane production in the early years of WWII.

chiefdave · 2025-03-09T13:11:17+0000

MalcSB said:
I made a comment on this thread a while ago about my generation having worked hard for what they got when younger, and immediately got jumped on by people saying that they also work hard. It would appear that you, for one, don’t and are extremely happy with your life and have everything you need. If that is the case, why are you having a pretty regular “go” at boomers.

Sky_Blue_Dreamer said:
This especially grates when some of them then go on to have a go at younger generations who don't have half of the stuff they have or had and just complain that they're lazy and just need to stop buying avocados and mochachocalattes.

Brighton Sky Blue said:
The difference is that an honest day's work doesn't get you as much as it did in the past and the work itself is generally less secure with worse conditions and benefits. No coincidence that this took place at the same time as a collapse in workplace organisation.

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.

CCFCSteve · 2025-03-09T14:11:29+0000

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.

MalcSB · 2025-03-09T15:22:23+0000

chiefdave said:
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.

CCFCSteve said:
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.

MalcSB · 2025-03-09T15:27:46+0000

chiefdave said:
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.

Sorry to hear bout your Dad's condition.

MalcSB · 2025-03-09T15:37:48+0000

CCFCSteve said:
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
Over time, many 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 ireplaceable liquid samples) 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. Then the next one, then the next one etc.

There will be variation between each patient as all people are different, despite some similarities. Perhaps standardisation is impossible

MalcSB · 2025-03-09T18:40:58+0000

Sky_Blue_Dreamer said:
I am aware that when retired pensioners would lose access to this. But hopefully due to the reduction in working age people accessing the service they should receive better/more care from the public health service.

The biggest issue with that of course is capacity, and creating additional overall capacity rather than at the moment, which appears to be the same capacity and more being diverted to private healthcare. But that is an issue whatever system you look at.

Wrong way round I think.

Demand is greater than NHS capacity.
Private sector have spare capacity.
Some NHS demand is already being diverted to private sector spare capacity as a means of increasing capacity = reduced waiting lists and waiting times.

An employee funded private health insurance scheme for employees, funded by employers, would make use of private sector capacity.
Therefore, increased capacity overall.

fernandopartridge · 2025-03-09T19:04:14+0000

MalcSB said:
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.

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.

I always think of the argument you've made when you read another study about the variation between prices paid for surgical gloves

fernandopartridge · 2025-03-09T19:05:33+0000

I think NHS procurement of common goods and services at national level ignores that suppliers treat each trust as a separate entity (because it is), so the supposed benefits of it are lost.

Sky_Blue_Dreamer · 2025-03-09T20:44:17+0000

Brighton Sky Blue said:
Was in Lesta on Friday and didn’t realise they had free buses doing a circular route around the city.

I think it's something we should consider. Have all the buses go to Pool Meadow and everything inside the ringroad served by a circular bus on a loop. Reduce the amount of vehicles in the city centre.

fernandopartridge · 2025-03-09T20:46:57+0000

Sky_Blue_Dreamer said:
I think it's something we should consider. Have all the buses go to Pool Meadow and everything inside the ringroad served by a circular bus on a loop. Reduce the amount of vehicles in the city centre.

It's not necessary in Coventry which is largely pedestrianised already, to the extent that buses do not reach anywhere more conveniently than any other form of transport.

MalcSB · 2025-03-09T22:23:15+0000

fernandopartridge said:
Consent manufacturing starts in earnest for defence spending

If the British Army now perceives that it doesn't have sufficient tanks and artillery to defend itself, what on earth did it give them to Ukraine for?

Very good point

Captain Dart · 2025-03-09T22:34:08+0000

I don't know what this implies but there is some sort of neighbourhood model simulation being run.

I think the focus is about less people and services in hospitals.

First ever simulation of the Neighbourhood Health Service planned for May 2025 - PPL

London, 20th February 2025 – a first simulation of how a ‘neighbourhood health service’ [part of the government’s proposed new model for the NHS] would operate in practice is being planned for May 2025 in London. This is believed to be the first simulation of the neighbourhood health approach to...

ppl.org.uk

MalcSB · 2025-03-09T22:34:51+0000

fernandopartridge said:
That's only 18% overall since Labour came to power promising to cut energy bills

18.4% as it will be a compound increase. That’s my triple lock gone.

MalcSB · 2025-03-09T22:38:16+0000

chiefdave said:
If you want another example of how the NHS works basically got told this is the treatment we can offer you but off the record there is far more effective treatment that isn't offered by the NHS so you'd need to go private and pay somewhere in the region of £5K.

The best part? The reason the treatment is not offered on the NHS is because of cost, the treatment they will offer will cost in the region of £8K. Make it make sense.

That’s the wankers called NICE for you.

MalcSB · 2025-03-09T22:41:52+0000

fernandopartridge said:
There are more peoplecompleting medical courses than there are training places, they have been oversubscribed for years:

UK’s foundation training programme for 2022 was oversubscribed by almost 800 places

The level of oversubscription to the 2022 UK foundation programme is higher than in previous years, with 791 students on the reserve list.1 The foundation programme has seen this trend for a number of years, having been oversubscribed by 258 in 2020 and by 494 in 2021 (see fig 1 and table). In...

www.bmj.com

Sorry, that’s out of date. Last two years 100% found a training place despite there being 1 less provider.

https://foundationprogramme.nhs.uk/wp-content/uploads/sites/2/2025/02/UKFP2025-Comparison-of-FP-allocation-results.pdf

MalcSB · 2025-03-09T22:51:34+0000

fernandopartridge said:
I always think of the argument you've made when you read another study about the variation between prices paid for surgical gloves

I think you work in NHS supply chain.

I managed at various levels in NHS hospitals and what I put in my lengthy response to your post about variation in the NHS was from my own genuine experience, including trying to make practical use of Model Hospital. Most definitely not from a read of a study. I’m going to have to find the one about surgical gloves. However, medics also have preferences for those as well.

It is really awful when you are using mismatched 12 * 75 mm tubes for storage of samples, some of which have pinholes in the base of the tube. You aliquot plasma, serum or even worse cerebrospinal fluid in to one of those, come to do the test a little later and the tube is empty with a small puddle of leaked sample underneath it. Which you can’t use.

Never mind, we almost saved some money. Shame about the baby with a possible meningitis.

MalcSB · 2025-03-09T22:59:34+0000

Captain Dart said:
I don't know what this implies but there is some sort of neighbourhood model simulation being run.

I think the focus is about less people and services in hospitals.

First ever simulation of the Neighbourhood Health Service planned for May 2025 - PPL

London, 20th February 2025 – a first simulation of how a ‘neighbourhood health service’ [part of the government’s proposed new model for the NHS] would operate in practice is being planned for May 2025 in London. This is believed to be the first simulation of the neighbourhood health approach to...

ppl.org.uk

As has been talked about for over 20 years.

Do you want to discuss boring politics? (24 Viewers)

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