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Post by Orac on Apr 29, 2024 17:07:13 GMT
Businesses can lose money and go bankrupt. The problem with state run enterprises is, that no matter how inept and corrupt they become, they never disappear down the pan.
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Post by cartertonian on Apr 29, 2024 17:16:12 GMT
True. Which is why people should be working towards ways of running those services that we cannot allow down the pan, like health, education, police, fire & rescue, defence, etc as efficiently and effectively as possible. Ergo, it was not appropriate to push the 'pseudo-business-model' in the first place. Let's remember when it was born - in the 'greed is good', Reagan/Thatcher neoliberal love-in of the mid-eighties, when the social bell-weather of success was a bloke in a suit with a filofax, and we ended up with an Army of Gordon Geckos marching into public service management.
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Post by Zany on Apr 29, 2024 17:31:47 GMT
I know it only anecdotal evidence, but when my wife left the NHS it was a standing joke that no one asked the staff how to do the job better. Pretty much every week she'd come home with a story about standing around for three hours because they are not allowed to fetch patients from the wards anymore or call the porters direct. It all had to be done through the new hub. Then three months later that would disappear. The time wasting was painful and made worse by the fact you then had to work late.
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Post by Zany on Apr 29, 2024 17:32:40 GMT
Businesses can lose money and go bankrupt. The problem with state run enterprises is, that no matter how inept and corrupt they become, they never disappear down the pan. The problem with making them businesses is they still can't be allowed to go bankrupt. Look at Thames water.
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Post by Orac on Apr 29, 2024 17:34:34 GMT
Businesses can lose money and go bankrupt. The problem with state run enterprises is, that no matter how inept and corrupt they become, they never disappear down the pan. The problem with making them businesses is they still can't be allowed to go bankrupt. Look at Thames water. As carty says, you can't make them business. The only way to have efficient public services is to start with a well enforced honesty ethic.
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Post by Zany on Apr 29, 2024 17:38:10 GMT
The problem with making them businesses is they still can't be allowed to go bankrupt. Look at Thames water. As carty says, you can't make them business. The only way to have efficient public services is to start with a well enforced honesty ethic. Wouldn't it be good if we actually saw those in charge held to account for their decisions. No more "Lessons will be learned"
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Post by Orac on Apr 29, 2024 17:43:22 GMT
Let's remember when it was born - in the 'greed is good', Reagan/Thatcher neoliberal love-in of the mid-eighties, when the social bell-weather of success was a bloke in a suit with a filofax, and we ended up with an Army of Gordon Geckos marching into public service management. The eighties were the last real decade,. However, the decade at the end of history was spoiled for everyone by the yuppies
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Steve
Hero Protagonist
Posts: 2,591
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Post by Steve on Apr 29, 2024 17:49:43 GMT
So what that says is the managers have been doing what the Tory ministers demanded they do. And it's the latter that's been a big problem. Every department pursuing its isolationist efficiency over all round NHS effectiveness..
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Post by Orac on Apr 29, 2024 20:45:35 GMT
As carty says, you can't make them business. The only way to have efficient public services is to start with a well enforced honesty ethic. Wouldn't it be good if we actually saw those in charge held to account for their decisions. No more "Lessons will be learned" It's certainly simpler to blame someone else. Do you remember when you were old that BLM marches wouldn't be super-spreader events because 'racism spreads the virus'? Do you remember when they told you that the outbreak of novel respiratory virus couldn't have anything to do with a novel respiratory virus laboratory a mile or two away? Two lies you accepted that you must have known were lies. Tell the truth and shame the devil.
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Post by Zany on Apr 29, 2024 21:24:52 GMT
Wouldn't it be good if we actually saw those in charge held to account for their decisions. No more "Lessons will be learned" It's certainly simpler to blame someone else. Do you remember when you were old that BLM marches wouldn't be super-spreader events because 'racism spreads the virus'? Do you remember when they told you that the outbreak of novel respiratory virus couldn't have anything to do with a novel respiratory virus laboratory a mile or two away? Two lies you accepted that you must have known were lies. Tell the truth and shame the devil. You're speaking in tongues again. I remember being told neither of those things and certainly would not have accepted them. My autism will not allow me to accept rubbish just because its convenient. Facts are facts.
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Post by Zany on Apr 30, 2024 6:57:48 GMT
So I guess the next question is what do we do about it. Baring in mind the government avidly read these posts. What would you change and in what order.
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Steve
Hero Protagonist
Posts: 2,591
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Post by Steve on Apr 30, 2024 8:28:09 GMT
As I posted elsewhere recently:
This is what I'd do (but it'll need an all party group to sell it to the public).
1. Make a public statement that we cannot fund an ever improving service to an ever average ageing population
2. Restrict GP visits by charging for them
3. Incentivise people going private by not only stopping private health being a taxable employment benefit but make all private health insurance fees and care home fees tax deductible
4. End the idiocy of fragmented groups all with individual targets that disincentivise effective solutions. Patients to have 'case managers' responsible for and able to draw together all the needed NHS services for a solution
5. Public statement (and policy) to the effect that 'if you want to inherit your parents house then you have to be the ones that provide old age care because if they need a care home and won't pay we're placing a charge on the house'
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Post by cartertonian on Apr 30, 2024 17:49:08 GMT
Re 2 and 4:
2. No. As I wrote earlier, we need a health service that is proactive and not reactive. Discouraging people from accessing primary care will cost more in the long run due to many missed opportunities for early diagnosis.
4. We don't need case managers; that is exactly what a GP is for.
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Post by Zany on Apr 30, 2024 18:47:26 GMT
Our GP surgery is brilliant, they seem to have all the boxes ticked. You ring and your told your in a queue and they will ring you back. And they do, usually within 15 minutes. You speak the a nurse who decides if you need to speak to a doctor or come in. If its a doctor they call you within 30 minutes if you need to come in your appointment is made according to need. They have direct contact with the local hospital, physio therapy unit etc. They make your appointments (timed according to need) Someone needs to ask them how they manage it. Mind you it didn't speed up my wifes op. Anyway I drift.
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Post by Zany on Apr 30, 2024 18:58:19 GMT
As I posted elsewhere recently: This is what I'd do (but it'll need an all party group to sell it to the public). 1. Make a public statement that we cannot fund an ever improving service to an ever average ageing population 2. Restrict GP visits by charging for them 3. Incentivise people going private by not only stopping private health being a taxable employment benefit but make all private health insurance fees and care home fees tax deductible 4. End the idiocy of fragmented groups all with individual targets that disincentive effective solutions. Patients to have 'case managers' responsible for and able to draw together all the needed NHS services for a solution 5. Public statement (and policy) to the effect that 'if you want to inherit your parents house then you have to be the ones that provide old age care because if they need a care home and won't pay we're placing a charge on the house' 1, Or that if you want all the latest treatments then tax will have to be a bigger part of your life. One less holiday or one less new drug. 2, They're already pretty rare. I do think you should be fined for missing an appointment. 3, I worry we get a two tier system, more than now. Already the wealth gap in the UK is too large , the worst country in Europe. Maybe some system where you don't get to use NHS doctors and surgeons. 4, I agree here, GP's are too busy and skilled to sort out paperwork. 5, And the right to end your life.
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