# Manifestos, Mandates and Mendacity



## SwingsitlikeHogan (Nov 4, 2015)

You voted Conservative this year.  They tell us that as a policy was in the manifesto and the electorate has given them a mandate, then they *must *deliver the policy - or are they being rather mendacious in saying that?

As a Conservative voter do you expect the government to deliver *everything* that was in the manifesto?  What do you do if they don't deliver everything - will you hold their feet to the fire?   Or did you vote for them without really knowing or supporting everything that was in their manifesto; and are thus not that bothered if some things don't come to pass.

Surely it cannot always be essential to deliver the full manifesto - if so then stop falling back on that argument and try and give us the common sense to understand that - despite you best intentions - some things just aren't as possible to do as might have been thought.

Listening to JHunt yesterday on the 7-day NHS, he kept falling back on 'it was in the manifesto - we are expected to deliver it'  Really?  Could they not just say that they tried but when they looked deeper they found it wouldn't work.  I'm sure an electorate - grateful for all that the Conservative government is achieving at the moment - will cut them some slack.


----------



## Hobbit (Nov 4, 2015)

I voted Conservative because I like the colour blue.


Actually, if it was in a manifesto I'd expect them to push it through as policy. And I agree with a 7 day NHS. Not achievable without lots of money being thrown at it, but I 100% agree with it. You can't pick and choose when you're ill... "oh, my appendics is grumbling... must wait till Monday."


----------



## Fyldewhite (Nov 4, 2015)

I didn't vote conservative but all politicians from all sides will state that a manifesto commitment is a "cornerstone" of what they were elected to do.......except when they can't deliver it or don't even try to deliver it......all part of the game. But to be fair, they can't win can they. If they say one thing then reconsider they are pilloried for a massive U-turn so it's no surprise they play the "manifest commitment" card whenever they can.


----------



## SwingsitlikeHogan (Nov 4, 2015)

Hobbit said:



			I voted Conservative because I like the colour blue.


Actually, if it was in a manifesto I'd expect them to push it through as policy. And I agree with a 7 day NHS. Not achievable without lots of money being thrown at it, but I 100% agree with it. You can't pick and choose when you're ill... "oh, my appendics is grumbling... must wait till Monday."
		
Click to expand...

OK - so you expect them to implement everything in the manifesto - no ifs no buts, and regardless of what those affected by any policy might think.  So government says _Tough.  It was in the manifesto - it must be delivered - if you don't like it blame those who voted for us._  That's how it works I guess.


----------



## MegaSteve (Nov 4, 2015)

I am waiting on them not to deliver a third runway at Heathrow...

As promised by DaveCam himself...


----------



## Foxholer (Nov 4, 2015)

The Mamifesto is a commitment/promise, so they would have to have a bloody good excuse to not implement what's in it!

That doesn't mean it won't be a shambolic piece of legislation that turns out to be a disaster or that it will actually be a good idea in the first place, or even actually has some sort of resemblance to what they told the electorate would happen all those years ago!

They are politicians! Mendacity is part of their nature - if not part of their breeding!


----------



## Hobbit (Nov 4, 2015)

SwingsitlikeHogan said:



			OK - so you expect them to implement everything in the manifesto - no ifs no buts, and regardless of what those affected by any policy might think.  So government says _Tough.  It was in the manifesto - it must be delivered - if you don't like it blame those who voted for us._  That's how it works I guess.
		
Click to expand...

Yes, pretty much. Don't forget, some people will have voted for them based on some of the things in the manifesto. And just because you think "tough" doesn't mean that someone else does. They might actually want it.


----------



## SwingsitlikeHogan (Nov 4, 2015)

Hobbit said:



			Yes, pretty much. Don't forget, some people will have voted for them based on some of the things in the manifesto. And just because you think "tough" doesn't mean that someone else does. They might actually want it.
		
Click to expand...

Indeed I am fully aware that many folk will want something based upon their own self interests - regardless of the impact it might have on others.


----------



## Lord Tyrion (Nov 4, 2015)

I would expect manifesto promises to be kept. They are why you vote for a party. Now where things change is that you can adapt, alter pledges etc to suit changing times, improve the policy. Pledges usually need tightening or improving when it comes down to the nitty gritty. That is essential. The gist should remain the same though. If not then you have been cheated.


----------



## CheltenhamHacker (Nov 4, 2015)

SwingsitlikeHogan said:



			Indeed I am fully aware that many folk will want something based upon their own self interests - regardless of the impact it might have on others.
		
Click to expand...

How did I know it would turn into this standard comment from yourself before long.

Tory votes = selfish, Labour voters = saviours of humanity.

Now we've stated that, you don't have to mention it again.


----------



## SwingsitlikeHogan (Nov 4, 2015)

CheltenhamHacker said:



			How did I know it would turn into this standard comment from yourself before long.

Tory votes = selfish, Labour voters = saviours of humanity.

Now we've stated that, you don't have to mention it again.
		
Click to expand...

Who mentioned Labour?  In fact I merely agreed with you that many people vote out of self interest.  Which is fine and dandy.

Point was about delivering full manifesto and whether voters basically *demand* it of their government - regardless.  Is there room to step back from a manifesto  promise without pain if the government realises the error of their ways - despite what those who voted for them might still want.

To be honest I am not sure that the 7-day NHS was one of the manifesto promises that the Tories trumpeted.  Maybe it was - but I don't recall much beyond austerity and Â£12Bn cuts.


----------



## Hobbit (Nov 4, 2015)

SwingsitlikeHogan said:



			Who mentioned Labour? * In fact I merely agreed with you* that many people vote out of self interest.  Which is fine and dandy.

Point was about delivering full manifesto and whether voters basically *demand* it of their government - regardless.  Is there room to step back from a manifesto  promise without pain if the government realises the error of their ways - despite what those who voted for them might still want.

To be honest I am not sure that the 7-day NHS was one of the manifesto promises that the Tories trumpeted.  Maybe it was - but I don't recall much beyond austerity and Â£12Bn cuts.
		
Click to expand...

Agreed with who? Its Cheltenham's first post in the thread.


----------



## SwingsitlikeHogan (Nov 4, 2015)

Hobbit said:



			Agreed with who? Its Cheltenham's first post in the thread.
		
Click to expand...

yes - sorry...I meant I was agreeing with you - not Cheltenham's


----------



## Hobbit (Nov 4, 2015)

I think its a bit more complex than who voted for who for what reasons. I want political parties to 'honour' their manifesto because that is (almost) what they are promising those that vote for them. However, what if someone(me) voted for them because they are, in my opinion, the best of a bad lot. I preferred more Cons manifesto 'promises' than Labour 'promises.'

Should they change their minds mid flow? If circumstances change, would anyone want them not to change.


----------



## sev112 (Nov 4, 2015)

So much easier being a Utopian Anarchist Communist - we don't have to worry about these things

PS what were those great things the Conservative govt are apparently delivering ?  Only obvious good thing they've done in recent times is shift Gove away from education where he can't cause any more grief


----------



## chrisd (Nov 4, 2015)

I think that a lot of us were rightly brassed off when the last manifesto was ditched because they went into coalition. Everyone was saying that we got the result we wanted simply because the vagaries of the system threw up a no overall majority, the fact was we didn't vote for a coalition and a freedom for the parties to both ditch their manifesto's


----------



## SwingsitlikeHogan (Nov 4, 2015)

Hobbit said:



			I think its a bit more complex than who voted for who for what reasons. I want political parties to 'honour' their manifesto because that is (almost) what they are promising those that vote for them. However, what if someone(me) voted for them because they are, in my opinion, the best of a bad lot. I preferred more Cons manifesto 'promises' than Labour 'promises.'

Should they change their minds mid flow? If circumstances change, would anyone want them not to change.
		
Click to expand...

That's fine - I that I get.  Then what if a government realises when looking into implementing a manifesto promise that the actual impact of what they had promised would be greater than they expected.  Is a government allowed to step away - or must they proceed regardless (I know this is very hypothetical).  They can use any other reason they want - but from what I hear here is that they would not be expected, and hence do not have to, implement every policy in their manifesto if they can give good reasons for not doing so.  And so if a government can step away then they should not use 'it's in the manifesto' as a reason for implementing a policy.  So dear JH - don't give me that as a reason for what you plan for the 7-day NHS - if you believe in it - do it - and don't pretend you do it so as not to let down the electorate who voted for you.


----------



## Ethan (Nov 4, 2015)

Hobbit said:



			I You can't pick and choose when you're ill... "oh, my appendics is grumbling... must wait till Monday."
		
Click to expand...

Oh dear. You have no idea about provision in the current NHS or what Hunt is trying to do. If your appendix starts to grumble on Saturday evening, you can have it out that night. Always have been able to. 

The data cited by Hunt about excess deaths has been shown to be rubbish. Even if it were true, all he is proposing is to distribute them over the rest of the week. Every extra doctor shift st the weekend is one fewer during the week. And what about lab staff, theatre staff, outpatient staff etc etc. Not a penny available for those. 

7 day working is to show private healthcare companies that the assets of the NHS can be sweated. 

I totally support the junior doctors and hope they strike. They have been messed around for decades and Hunt's latest promise is simply his biggest lie to date. Hunt is responsible for the exodus of doctors overseas. This winter is going to break the NHS.


----------



## Hobbit (Nov 5, 2015)

Ethan said:



			Oh dear. You have no idea about provision in the current NHS or what Hunt is trying to do. If your appendix starts to grumble on Saturday evening, you can have it out that night. Always have been able to. 

7 day working is to show private healthcare companies that the assets of the NHS can be sweated. 

I totally support the junior doctors and hope they strike. They have been messed around for decades and Hunt's latest promise is simply his biggest lie to date. Hunt is responsible for the exodus of doctors overseas. This winter is going to break the NHS.
		
Click to expand...

Hahahahahaha - having had my appendix out on a Friday night, I think I have a pretty good idea about provision. Having been called in many times to theatres or ICU I know that in an emergency, pretty much all of the facilities needed are available. What isn't available is Outpatients clinics, and at weekends how many theatres are running lists. Nice idea to have more up-time but...

7 day working, without at least a 40% increase in budgets, is pie in the sky. Extra clinic time would mean extra theatre time would mean extra ward time. All of which would need extra staff. It isn't going to happen anywhere near the level of sound bite JH has been spouting.

As for this winter is going to break the NHS... have you taken to writing the headlines for the Express?


----------



## Sweep (Nov 5, 2015)

I do expect parties of all political persuasions to deliver on their manifesto once they are elected. TBH I would go further and enshrine it into law that they do so. That way, they may be a bit more careful about what they promise and how else are those who don't blindly support a particular party supposed to decide who to vote for? I think it is wrong that parties can potentially get into government on promises that can be ditched the next day.
I remember the smoking ban, for example. Labour promised they would ban smoking but allow smoking rooms. They were quite specific. Once elected, they decided to have a debate on how far the ban should go. Whether you agree with it or not (and I do) this was not what people had voted for.


----------



## Sweep (Nov 5, 2015)

Ethan said:



			I totally support the junior doctors and hope they strike. They have been messed around for decades and Hunt's latest promise is simply his biggest lie to date. Hunt is responsible for the exodus of doctors overseas. This winter is going to break the NHS.
		
Click to expand...

I hope they go on strike too and then people can die to prove they were right 
Like it or not, the 7 day NHS was in their manifesto and that is what the majority voted for.
Whilst I don't think being a doctor can be all about a vocation, I do think that more consideration has to be given to the fact that the nation has paid to train them and given them a well paid profession for life. I had to pay for my training and progression in my career like millions of others. My job doesn't stop outside "social hours" just like millions of others. Those marching with placards stating "I am off to Oz" may want to think about that.
TBH the public sector need to get real. Constant striking just because they don't like a Tory led government isn't going to get anywhere and public opinion soon wanes. What good did the teachers strikes do? None. Because they striked on pensions that are way better than any in the private sector can ever dream of and it's the private sector that pays for everything. 2 strikes in and the public lost patience. Now, if the PRIVATE sector went on strike, you would really know about it. You wouldn't even eat.


----------



## Deleted member 16999 (Nov 5, 2015)

Maybe I'm being too simplistic, but i honestly think the majority of voters vote for who they like, were they live or their circumstances or what they see/hear in the media, regardless of what's in a manifesto, a,b and c will get x, y and z's vote.
Sad, maybe, but in my honest opinion, reality, that's why at times when people are questioned about who they vote for it's not actually based on the manifesto.


----------



## SwingsitlikeHogan (Nov 5, 2015)

pauldj42 said:



			Maybe I'm being too simplistic, but i honestly think the majority of voters vote for who they like, were they live or their circumstances or what they see/hear in the media, regardless of what's in a manifesto, a,b and c will get x, y and z's vote.
Sad, maybe, but in my honest opinion, reality, that's why at times when people are questioned about who they vote for it's not actually based on the manifesto.
		
Click to expand...

This is the heart of my OP.  The government claims their electoral mandate means that they must implement their manifesto - as that is what the voters have asked them to do by voting for them.  Really?  Everything in the manifesto?   I think it is disingenuous for the government to proclaim that they *must* implement the 7-day NHS on the grounds that it was in the manifesto.  If they can give good reasons why their subsequent detailed investigations and planning shows that the concept is either flawed, unworkable or unfair, would the electorate who voted for them not understand?  I think it would.


----------



## Hobbit (Nov 5, 2015)

SwingsitlikeHogan said:



			This is the heart of my OP.  The government claims their electoral mandate means that they must implement their manifesto - as that is what the voters have asked them to do by voting for them.  Really?  Everything in the manifesto?   I think it is disingenuous for the government to proclaim that they *must* implement the 7-day NHS on the grounds that it was in the manifesto.  If they can give good reasons why their subsequent detailed investigations and planning shows that the concept is either flawed, unworkable or unfair, would the electorate who voted for them not understand?  I think it would.
		
Click to expand...

I think that if a party isn't going to follow a manifesto pledge they absolutely have to tell the electorate why. I can remember voting Labour in the Tony Blair years, only for Labour to totally renage on a major manifesto pledge. I've not voted for them since, not that they've exactly excited me either.

But, with massive investment, why can't we have a 7 day NHS?


----------



## SwingsitlikeHogan (Nov 5, 2015)

Hobbit said:



			I think that if a party isn't going to follow a manifesto pledge they absolutely have to tell the electorate why. I can remember voting Labour in the Tony Blair years, only for Labour to totally renage on a major manifesto pledge. I've not voted for them since, not that they've exactly excited me either.

But, with massive investment, why can't we have a 7 day NHS?
		
Click to expand...

I agree - I think that government should feel able to walk away from implementation of a policy if the explain why.

On the 7-day NHS - some would argue that we already have it.  Besides - just looking at doctors and consultants for whom weekend working is not core hours - what are mothers of young children going to do when they have to work weekends.  OK - they'll have to do what mothers who work weekends have to do.  But is this not going to be a distinct disincentive for females to go into that profession if they know they'll have to work weekends.  And if we start losing female doctors and fewer join the profession how does that match up with having to employ MORE doctors and consultants than currently are employed to cover working weekends?

A lot of practical stuff and you do have to ask whether it is really justified.  More folks die at weekends?  Well maybe more folks go into hospital with life threatening conditions at weekends because it is the weekend...

It sounds great - I'm not so sure.


----------



## Hobbit (Nov 5, 2015)

SwingsitlikeHogan said:



			I agree - I think that government should feel able to walk away from implementation of a policy if the explain why.

On the 7-day NHS - some would argue that we already have it.  Besides - just looking at doctors and consultants for whom weekend working is not core hours - what are mothers of young children going to do when they have to work weekends.  OK - they'll have to do what mothers who work weekends have to do.  But is this not going to be a distinct disincentive for females to go into that profession if they know they'll have to work weekends.  And if we start losing female doctors and fewer join the profession how does that match up with having to employ MORE doctors and consultants than currently are employed to cover working weekends?

A lot of practical stuff and you do have to ask whether it is really justified.  More folks die at weekends?  Well maybe more folks go into hospital with life threatening conditions at weekends because it is the weekend...

It sounds great - I'm not so sure.
		
Click to expand...

We do not have a 7 day NHS, absolutely definitely don't! Colour it whichever way you want but it doesn't exist. Go into any large hospital and have a wander around Outpatients dept on, say, a Tuesday and a Sunday. Its a ghost town on a Sunday. Go into an operating theatre block on a Sunday compared to a weekday and you'll see similar. However, unless it was fully staffed 7 days a week, its not workable. And even if those depts were staffed 7 days a week, where are the beds to support that increase in throughput?

I dare say more people do die at weekends, irrespective of what doctors say. Try and find top surgeons etc on a Saturday and a Sunday. I know of one member of staff for whom a hospital called in the top team rather than have the duty Registrar operate... anecdotal I know, but it does happen.


----------



## hors limite (Nov 5, 2015)

:whoo:



CheltenhamHacker said:



			How did I know it would turn into this standard comment from yourself before long.

Tory votes = selfish, Labour voters = saviours of humanity.

Now we've stated that, you don't have to mention it again.
		
Click to expand...


----------



## Deleted member 16999 (Nov 5, 2015)

SwingsitlikeHogan said:



			This is the heart of my OP.  The government claims their electoral mandate means that they must implement their manifesto - as that is what the voters have asked them to do by voting for them.  Really?  Everything in the manifesto?   I think it is disingenuous for the government to proclaim that they *must* implement the 7-day NHS on the grounds that it was in the manifesto.  If they can give good reasons why their subsequent detailed investigations and planning shows that the concept is either flawed, unworkable or unfair, would the electorate who voted for them not understand?  I think it would.
		
Click to expand...

There is a difference between a Party in Government and an opposition, the opposition manifesto is based on what they intend to do, but can't really cost it until they see the books, if they lose, so what. If they win, blame the previous Government if the finance is not there.
Issue this time, Tories really should've produced a balanced, thought out manifesto, they had the books.


----------



## SwingsitlikeHogan (Nov 5, 2015)

pauldj42 said:



			There is a difference between a Party in Government and an opposition, the opposition manifesto is based on what they intend to do, but can't really cost it until they see the books, if they lose, so what. If they win, blame the previous Government if the finance is not there.
*Issue this time, Tories really should've produced a balanced, thought out manifesto, they had the books.*

Click to expand...

Which is why I am astonished that they have got into a mess over Tax Credits.  How could they not have know the impact it was going to have.  Unless they did and all this we are seeing, and what we will hear in the autumn statement on the 25th, is all part of the plan...


----------



## HomerJSimpson (Nov 5, 2015)

I may be cynical or just plain deluded but I'm voting at an election knowing full well whoever gets in isn't going to deliver on everything in the manifesto. These days I just hope the party in power leave the country in a better state than when they took over. Not always convinced this is the case either. What's the alternative? No one will stick to their promises and frequently move the goal posts


----------



## SwingsitlikeHogan (Nov 5, 2015)

HomerJSimpson said:



			I may be cynical or just plain deluded but I'm voting at an election knowing full well whoever gets in isn't going to deliver on everything in the manifesto. These days I just hope the party in power leave the country in a better state than when they took over. Not always convinced this is the case either. What's the alternative? No one will stick to their promises and frequently move the goal posts
		
Click to expand...

Quite - all governments implement the aspects of their manifesto that they *want *to - not because they *have* to.   Hunt is being disingenuous to suggest he *has* to implement a 7-day NHS because it is in the manifesto.  He is pushing it through because the government wants it.  Which is fine, just don't pretend otherwise.


----------



## Sweep (Nov 5, 2015)

SwingsitlikeHogan said:



			I agree - I think that government should feel able to walk away from implementation of a policy if the explain why.

On the 7-day NHS - some would argue that we already have it.  Besides - just looking at doctors and consultants for whom weekend working is not core hours - what are mothers of young children going to do when they have to work weekends.  OK - they'll have to do what mothers who work weekends have to do.  But is this not going to be a distinct disincentive for females to go into that profession if they know they'll have to work weekends.  And if we start losing female doctors and fewer join the profession how does that match up with having to employ MORE doctors and consultants than currently are employed to cover working weekends?

A lot of practical stuff and you do have to ask whether it is really justified.  More folks die at weekends?  Well maybe more folks go into hospital with life threatening conditions at weekends because it is the weekend...

It sounds great - I'm not so sure.
		
Click to expand...

We don't have a 7 day NHS. At my local surgery you can't get an appointment within the next 3 weeks! Seriously, what do you do if you are ill? Just wait 3 weeks?
I am all for a 7 day NHS and I will tell you why. I pay for it. I pay a lot for it, like every other tax payer in this country. I am sorry doctors don't want to work on Saturdays, but then neither do I. I don't get paid any more for it and I don't get another day off in lieu if I do. It shouldn't be 7 day. It should be 24 hours a day, 7 days a week. With a rising population we can't have anything else other than a 24/7 service.
Just imagine if it worked. The Tories doing better with the NHS than Labour, after all the accusations of them killing it off!
Maybe you think the government should walk away from this particular manifesto policy because you don't like it?


----------



## Hobbit (Nov 5, 2015)

SwingsitlikeHogan said:



			Quite - all governments implement the aspects of their manifesto that they *want *to - not because they *have* to.   Hunt is being disingenuous to suggest he *has* to implement a 7-day NHS because it is in the manifesto.  He is pushing it through because the government wants it.  Which is fine, just don't pretend otherwise.
		
Click to expand...

Not sure I 100% agree with you there. Yes they implement what they want to. But, equally, if they don't implement something in their manifesto they run the risk of being disingenuous unless they can genuinely show their original manifesto promise was flawed. Sorry, but I really feel you're playing with words to suit your own feelings/agenda on the issue.


----------



## Deleted member 16999 (Nov 5, 2015)

Hobbit said:



			Not sure I 100% agree with you there. Yes they implement what they want to. But, equally, if they don't implement something in their manifesto they run the risk of being disingenuous unless they can genuinely show their original manifesto promise was flawed. Sorry, but I really feel you're playing with words to suit your own feelings/agenda on the issue.
		
Click to expand...

But doesn't Homers post sum up voter apathy, those that took the time or interest in manifesto's are few and far between.


----------



## Hobbit (Nov 5, 2015)

pauldj42 said:



			But doesn't Homers post sum up voter apathy, those that took the time or interest in manifesto's are few and far between.
		
Click to expand...

That's a tough one. Voter numbers have dropped off massively in the last xx elections. Maybe the hardcore that do vote take a bigger interest than some give them credit for...?


----------



## Deleted member 16999 (Nov 5, 2015)

Hobbit said:



			That's a tough one. Voter numbers have dropped off massively in the last xx elections. Maybe the hardcore that do vote take a bigger interest than some give them credit for...?
		
Click to expand...

But the hardcore are also probably the diehard party supporters, the floating voter are, imo, influenced by short term goals, selfishness and the media.


----------



## Ethan (Nov 6, 2015)

Hobbit said:



			Hahahahahaha - having had my appendix out on a Friday night, I think I have a pretty good idea about provision. Having been called in many times to theatres or ICU I know that in an emergency, pretty much all of the facilities needed are available. What isn't available is Outpatients clinics, and at weekends how many theatres are running lists. Nice idea to have more up-time but...

7 day working, without at least a 40% increase in budgets, is pie in the sky. Extra clinic time would mean extra theatre time would mean extra ward time. All of which would need extra staff. It isn't going to happen anywhere near the level of sound bite JH has been spouting.

As for this winter is going to break the NHS... have you taken to writing the headlines for the Express?
		
Click to expand...

The Express is more concerned about the tropical cyclones about to hit Essex.

The NHS is in such a parlous state that a bad winter will be unsustainable. The problem is that this crisis is more or less designed. Hunt knows exactly the pressure the NHS is under but he is gambling that eventually the public will accept a switch to private companies running it. It is the old model. Run public services down until almost anything else is acceptable.

But there is plenty of money going into the NHS. It is just a pity so much is wasted on PFI payments, the apparatus of pseudo-market structures and the like. 

As for weekend clinics, there really isn't much public appetite for them. Likewise GP surgeries on Sundays, which have a lower booking rate and a higher DNA rate than weekdays. The problem is that these weekend clinics displace staff from the week, even if they are sitting around twiddling their thumbs. If Hunt is correct that the so-called weekend effect is due to staffing reduction at the weekend, then he is proposing a similar reduction during the week by moving staffing to the weekend. There is ample evidence that the weekend effect is not due to staffing but to higher levels of morbidity instead, so called case-mix, but Hunt prefers a political soundbite. There is therefore no guarantee that greater staffing at the weekend will make a difference, but a risk it would worsen outcomes during the week. So the possibility exists that this Don Quixote strategy will worsen matters and do so at massive cost. 

Of course we know that 7 day working is driven by private healthcare companies who have indicated that their level of interest in buying franchises in the NHS would be increased if they saw a flexible workforce capable of being deployed as they saw fit. it is a kern version of the old breaking of what they see a restrictive working practices.


----------



## Ethan (Nov 6, 2015)

Sweep said:



			We don't have a 7 day NHS. At my local surgery you can't get an appointment within the next 3 weeks! Seriously, what do you do if you are ill? Just wait 3 weeks?
I am all for a 7 day NHS and I will tell you why. I pay for it. I pay a lot for it, like every other tax payer in this country. I am sorry doctors don't want to work on Saturdays, but then neither do I. I don't get paid any more for it and I don't get another day off in lieu if I do. It shouldn't be 7 day. It should be 24 hours a day, 7 days a week. With a rising population we can't have anything else other than a 24/7 service.
Just imagine if it worked. The Tories doing better with the NHS than Labour, after all the accusations of them killing it off!
Maybe you think the government should walk away from this particular manifesto policy because you don't like it?
		
Click to expand...

You don't pay a lot for it. You pay one of the lowest amounts in the civilised world, actually, and if you are not a high earner, you get a bargain. So you are happy with fewer doctors around during the week and therefore, if Hunt is correct, a higher death rate for weekday admissions? And also happy to pay more tax to fund it?

Do you work 60 hours a week already performing tasks for which 100% concentration and wakefulness are needed? Not sure that many normal weekend jobs require the focus needed to perform surgery or diagnose a tricky chest pain. 

So you want 24/7 NHS. What does that mean, exactly? Diabetic clinics at 2 in the morning? Please explain what you understand by a 7 day NHS. If you can, you will be one up on Jeremy Hunt because he hasn't.


----------



## Hobbit (Nov 6, 2015)

Ethan said:



			The Express is more concerned about the tropical cyclones about to hit Essex.

The NHS is in such a parlous state that a bad winter will be unsustainable. The problem is that this crisis is more or less designed. Hunt knows exactly the pressure the NHS is under but he is gambling that eventually the public will accept a switch to private companies running it. It is the old model. Run public services down until almost anything else is acceptable.

But there is plenty of money going into the NHS. It is just a pity so much is wasted on PFI payments, the apparatus of pseudo-market structures and the like. 

As for weekend clinics, there really isn't much public appetite for them. Likewise GP surgeries on Sundays, which have a lower booking rate and a higher DNA rate than weekdays. The problem is that these weekend clinics displace staff from the week, even if they are sitting around twiddling their thumbs. If Hunt is correct that the so-called weekend effect is due to staffing reduction at the weekend, then he is proposing a similar reduction during the week by moving staffing to the weekend. There is ample evidence that the weekend effect is not due to staffing but to higher levels of morbidity instead, so called case-mix, but Hunt prefers a political soundbite. There is therefore no guarantee that greater staffing at the weekend will make a difference, but a risk it would worsen outcomes during the week. So the possibility exists that this Don Quixote strategy will worsen matters and do so at massive cost. 

Of course we know that 7 day working is driven by private healthcare companies who have indicated that their level of interest in buying franchises in the NHS would be increased if they saw a flexible workforce capable of being deployed as they saw fit. it is a kern version of the old breaking of what they see a restrictive working practices.
		
Click to expand...

Why isn't there much public appetite for weekend appointments in Outpatients? At a more base level, a mid week appointment means some people get a (legitimate) day off work. And from a business/Govt perspective its a day of lost production. Personally, do I want to miss my 9:30am tee time or appointment at Outpatients? I guess it depends on how ill I am.

I'm not sure I understand the reasoning for an increased morbidity rate at weekends. I can't see death, like illnesses in general, having a particular bio-clock. Do you have anything to back up the why...

Unless JH has got some massive funding pot stashed away, I can't see a 7 day NHS being worthwhile. Yes if it increases facilities/infrastructure and staff, but no if it only means moving some staff from mid-week to weekends. Having 5+0=5, and moving it to weekends might see the equation reading 3+2=5... no benefit, but a lot of stressed staff because they are thinner on the ground on any given day.


----------



## Sweep (Nov 6, 2015)

Ethan said:



			You don't pay a lot for it. You pay one of the lowest amounts in the civilised world, actually, and if you are not a high earner, you get a bargain. So you are happy with fewer doctors around during the week and therefore, if Hunt is correct, a higher death rate for weekday admissions? And also happy to pay more tax to fund it?

Do you work 60 hours a week already performing tasks for which 100% concentration and wakefulness are needed? Not sure that many normal weekend jobs require the focus needed to perform surgery or diagnose a tricky chest pain. 

So you want 24/7 NHS. What does that mean, exactly? Diabetic clinics at 2 in the morning? Please explain what you understand by a 7 day NHS. If you can, you will be one up on Jeremy Hunt because he hasn't.
		
Click to expand...

Yes, I do work 60 hours a week -and more when needed and you will find that a lot of people do. As I understand it, the doctors are not expected to work more hours, just different hours on different days and they get an 11% pay increase into the bargain. The need for more doctors is a seperate issue. If more are needed to operate a 7 day service then more should be recruited. I do believe that the money that the NHS receives could be used more efficiently.
The amount I pay into the NHS in my taxes is the biggest "policy" I have, by far, so I do pay a lot for it. On top of that, it is getting harder and harder to access its services. As I say, a 3 week and counting wait for an appointment at my surgery, but it's closed at weekends and before 8am and after 6pm in the week. Can you imagine any business in the private sector that would only open those hours if they were so busy?
A 7 day NHS is exactly what it says on the tin. 24/7/365. That is what would happen if the private sector actually did run the NHS. And you cannot ignore the point that with a rapidly expanding population, we cannot keep this service going with anything less. There simply is not the time and it's all part of understanding that more people does not simply mean more tax. Every single person needs investment in amenities, like education, transport, water services etc etc and yes, the NHS.
Lets look at it another way. Would you be happy with a reduction of hours? No? So do we have it about right then? If that is the case, why are people dying on waiting lists and others can't even get to see their GP within the next 3 weeks?


----------



## bluewolf (Nov 6, 2015)

Sweep said:



			Yes, I do work 60 hours a week -and more when needed and you will find that a lot of people do. As I understand it, the doctors are not expected to work more hours, just different hours on different days and they get an 11% pay increase into the bargain. The need for more doctors is a seperate issue. If more are needed to operate a 7 day service then more should be recruited. I do believe that the money that the NHS receives could be used more efficiently.
The amount I pay into the NHS in my taxes is the biggest "policy" I have, by far, so I do pay a lot for it. On top of that, it is getting harder and harder to access its services. As I say, a 3 week and counting wait for an appointment at my surgery, but it's closed at weekends and before 8am and after 6pm in the week. Can you imagine any business in the private sector that would only open those hours if they were so busy?
A 7 day NHS is exactly what it says on the tin. 24/7/365. That is what would happen if the private sector actually did run the NHS. And you cannot ignore the point that with a rapidly expanding population, we cannot keep this service going with anything less. There simply is not the time and it's all part of understanding that more people does not simply mean more tax. Every single person needs investment in amenities, like education, transport, water services etc etc and yes, the NHS.
Lets look at it another way. Would you be happy with a reduction of hours? No? So do we have it about right then? If that is the case, why are people dying on waiting lists and others can't even get to see their GP within the next 3 weeks?
		
Click to expand...

In reference to the "Surgery appointments" comments, have you considered changing Surgery? My local Surgery is already open 7 days a week (albeit with reduced staffing at the weekend).. I've never had to wait more than a few days for an appointment, and when I've really needed to see a Doctor I've been able to visit an "out of hours" surgery, that I'm fairly certain all towns have..


----------



## Hobbit (Nov 6, 2015)

TBH, going private gives far better access to medical care. I've had private healthcare for 20yrs, and its brilliant. Access to good Consultants, not spotty house doctors. Access to an MRI, not starting with an x-ray. It costs but its money well spent. I'd love to put the portion of money I'm paying in NI into more private healthcare, or alternatively pay what I'm paying for private healthcare into the NHS for the same level of care.

Appointment with the local GP starts with a ring back from the Practice Nurse, and then either a call from the GP or an appointment. 3 days for a ring back from the nurse, and 2 weeks for a call from the GP. 3 weeks to see him. Referred to the local BUPA, and seen within two days...


----------



## Ethan (Nov 6, 2015)

Sweep said:



			Yes, I do work 60 hours a week -and more when needed and you will find that a lot of people do. *As I understand it, the doctors are not expected to work more hours, just different hours on different days and they get an 11% pay increase into the bargain*. The need for more doctors is a seperate issue. If more are needed to operate a 7 day service then more should be recruited. I do believe that the money that the NHS receives could be used more efficiently.
The amount I pay into the NHS in my taxes is the biggest "policy" I have, by far, so I do pay a lot for it. On top of that, it is getting harder and harder to access its services. As I say, a 3 week and counting wait for an appointment at my surgery, but it's closed at weekends and before 8am and after 6pm in the week. Can you imagine any business in the private sector that would only open those hours if they were so busy?
A 7 day NHS is exactly what it says on the tin. 24/7/365. That is what would happen if the private sector actually did run the NHS. And you cannot ignore the point that with a rapidly expanding population, we cannot keep this service going with anything less. There simply is not the time and it's all part of understanding that more people does not simply mean more tax. Every single person needs investment in amenities, like education, transport, water services etc etc and yes, the NHS.
Lets look at it another way. Would you be happy with a reduction of hours? No? So do we have it about right then? If that is the case, why are people dying on waiting lists and others can't even get to see their GP within the next 3 weeks?
		
Click to expand...

You understand it wrongly. Hunt promised an 11% increase in basic pay but also a reduction in overtime, so most doctors will gain nothing and many will get a reduction. 

You pay for the NHS out of general taxation. National Insurance is not hypothecated for health. Sorry if you feel you pay a lot - you really don't/ Move to America if you want to know what paying a lot for healthcare looks like. 

As for ease of access, that is because a greater proportion of medical time is devoted to useless form filling. My wife is a Consultant Psychiatrist, and it used to be that every new patient she saw it took roughly the same amount of time to complete the paperwork as it did to see them. Now it takes 3 to 4 times as along. She has to complete radicalisation forms, dangerousness forms, a lot of coding designed to make future billing procedures easier. That has effectively extended her waiting list because there only is so much time in the week, and the Trust is full of people whose job it is to harass staff to get these forms filled in, which further increases cost and waste. The same happens in general practice, and they also have to deal with the nonsensical procedures for referrals. When I was doing hospital clinics, if I was doing a general medicine clinic and saw someone with a dermatology problem, say, I could pick up the phone, call round to the derm clinic and ask if they could say the patient today. No longer. I would now have to write to the GP and ask the GP to make a referral to the derm clinic. Why? Because that would count as a new patient and be billable as such. So the GP writes a new referral, it comes into hospital where it is screened by an admin who rejects it is some irrelevant box isn't properly filled in, because that helps manage their patient flow and waiting times. Likewise prescriptions. I used to issue prescriptions you could take to the pharmacy. No more, now the GP gets a letter asking them to prescribe.

You are kidding yourself if you think the NHS has learned anything from the private sector. The best companies value their staff. The NHS treats theirs with contempt. 

You haven't answered the question about 24/7 services, though. "exactly what it says on the tin". Do you mean routine clinics on weekends, elective operations and investigations, full diagnostics, facilities and all? If so start looking for another Â£30 billion a year. 

As for the weekend effect, read further than the Daily Mail. The BMJ, which published the paper that Hunt refers to (which was conducted by some of his own staff, by the way) had to issue a statement refuting Hunt's soundbite, and even one of the paper's authors had to do the same. There was also evidence published last week that Sunday clinics in GP have a very low and wasteful uptake and early pilots in them are closing down. I know lots of GPs and there is not one of them who finds the current state of GP tolerable, and most would retire or leave tomorrow if they could. If you want to blame someone for your not being able to get a GP appointment, blame Jeremy Hunt.


----------



## Sweep (Nov 7, 2015)

So at least you agree with me that the funds the NHS receives could be better spent. The way the NHS completes its paperwork has little to do with the need for a 7 day NHS, though I am sure if it was better handled, more patients could be seen within current hours.
I did answer your question on what 7 day means. The NHS needs to be run like it would if it was earning not spending money. For example, the last time I needed to see a doctor I phoned for an appointment and the phone rang out for maybe an hour. In the end I gave up and went round to the surgery. When I was granted my appointment for 3 weeks time on the proviso I hadn't died in the meantime, I asked why my call hadn't been answered. I explained to the receptionist the real reason. When the phone rings in in my company, it's an opportunity to sell, to make the money we need to survive. When the phone rings at my surgery, it's just someone like me who is going to cost some of the money they have already been given. It's all done the wrong way round. The NHS should be given funds on the basis of the number of people it serves. Just like everyone else. Then you would see the appetite for 7 day change. 
Obviously, if there is not enough custom for a diabetes clinic 24/7 then you put the resources where they are needed, but as soon as there is demand it should absolutely be 7 day.
Now, you didn't answer my question on how are we going to cope with a rapidly expanding population without a 7 day NHS?


----------



## delc (Nov 7, 2015)

P



MegaSteve said:



			I am waiting on them not to deliver a third runway at Heathrow...

As promised by DaveCam himself...
		
Click to expand...

What's the point of a third runway anyway? The roads around Heathrow are getting so gridlocked these days that you would never get there!


----------



## Ethan (Nov 7, 2015)

Sweep said:



			So at least you agree with me that the funds the NHS receives could be better spent. The way the NHS completes its paperwork has little to do with the need for a 7 day NHS, though I am sure if it was better handled, more patients could be seen within current hours.
I did answer your question on what 7 day means. The NHS needs to be run like it would if it was earning not spending money. For example, the last time I needed to see a doctor I phoned for an appointment and the phone rang out for maybe an hour. In the end I gave up and went round to the surgery. When I was granted my appointment for 3 weeks time on the proviso I hadn't died in the meantime, I asked why my call hadn't been answered. I explained to the receptionist the real reason. When the phone rings in in my company, it's an opportunity to sell, to make the money we need to survive. When the phone rings at my surgery, it's just someone like me who is going to cost some of the money they have already been given. It's all done the wrong way round. The NHS should be given funds on the basis of the number of people it serves. Just like everyone else. Then you would see the appetite for 7 day change. 
Obviously, if there is not enough custom for a diabetes clinic 24/7 then you put the resources where they are needed, but as soon as there is demand it should absolutely be 7 day.
Now, you didn't answer my question on how are we going to cope with a rapidly expanding population without a 7 day NHS?
		
Click to expand...

I am sorry, but you are wrong. Time stolen from clinical contact time has everything to do with the increasing demands and reducing availability in the NHS. If doctors are filling in useless forms, they are not seeing patients at the same time. It is elementary and obvious. 

And the political argument for 7 day NHS has little to do with demographic change. Health services can be provided to a larger population in precisely the same way it is now, although you will need more premises and staff. More people don't drive a need for displacement of activity to weekends and out of hours. 

In any case we already have a 7 day NHS, and have had once since the NHS was founded. That is for emergency need, although if you are ever in an A&E on a Saturday night you will see many which are far from emergencies. What you are presumably arguing for, although I am not sure you even know what you mean, is a full routine and elective service running at weekend, 24/7 or something. I don't think you really understand the implications of either one. Unless there is a large expansion in staff, and there is no money for that, then the best you can do is displace activity from weekdays to weekends. Then next time you ring the GP surgery, it will be 4 weeks for that appointment instead of 3. The cost for that full 7 day service is tens of billions. 

The NHS is a supply based system, not a demand based one (like in the US). Demand in healthcare is different from demand in whatever market you work in. Many of the people who demand healthcare don't actually need it, or don't need it right away. It is amazing how many minor niggles go away when you ask people to wait a few days or weeks. Giving funds on the basis of demand is a recipe for uncontrolled and uncontrollable cost inflation, like they have in the US, where they pay twice as much for somewhat less actual healthcare. You simply can't rely on people's good sense because many don't have any.


----------



## Liverpoolphil (Nov 7, 2015)

delc said:



			P

What's the point of a third runway anyway? The roads around Heathrow are getting so gridlocked these days that you would never get there!  

Click to expand...

Because London needs another runway to cope with increased air travel


----------



## delc (Nov 7, 2015)

Liverpoolphil said:



			Because London needs another runway to cope with increased air travel
		
Click to expand...

No point if you can't get to and from the airport in a reasonable time! You would also need to spend money on the surrounding roads, particularly the M25.


----------



## Liverpoolphil (Nov 7, 2015)

delc said:



			No point if you can't get to and from the airport in a reasonable time! You would also need to spend money on the surrounding roads, particularly the M25.
		
Click to expand...

I have never had any issue getting to either Heathrow or Gatwick in reasonable time ? I plan my journey accordingly 

Wouldn't need to change much with the M25


----------



## MegaSteve (Nov 7, 2015)

Liverpoolphil said:



			Because London needs another runway to cope with increased air travel
		
Click to expand...


It may well do.... But, it shouldn't be built at Heathrow purely because Dave's mates will be out of pocket otherwise...


----------



## Liverpoolphil (Nov 7, 2015)

MegaSteve said:



			It may well do.... But, it shouldn't be built at Heathrow purely because Dave's mates will be out of pocket otherwise...
		
Click to expand...

Well where is should be built I have no idea but there does need to be more facilities for more flights to land in London 

Heathrow would be a logical choice for it to go


----------



## HomerJSimpson (Nov 7, 2015)

Liverpoolphil said:



			Well where is should be built I have no idea but there does need to be more facilities for more flights to land in London 

Heathrow would be a logical choice for it to go
		
Click to expand...

I actually think there is a strong argument for Gatwick and there does seem to be serious hints that it might not happen

http://files.heraldscotland.com/pol...veering_away_from_Heathrow_expansion/?ref=rss


----------



## MegaSteve (Nov 7, 2015)

Liverpoolphil said:



			Heathrow would be a logical choice for it to go
		
Click to expand...


I am sure the good residents of Gatwick and Stansted will be more than happy to see an extra runway built in their locality... Brings great benefits to the area [apparently]....


----------



## Liverpoolphil (Nov 7, 2015)

MegaSteve said:



			I am sure the good residents of Gatwick and Stansted will be more than happy to see an extra runway built in their locality... Brings great benefits to the area [apparently]....
		
Click to expand...

Would do - just need to improve the rail links to both as well.


----------



## SwingsitlikeHogan (Nov 7, 2015)

Ethan said:



			I am sorry, but you are wrong. Time stolen from clinical contact time has everything to do with the increasing demands and reducing availability in the NHS. If doctors are filling in useless forms, they are not seeing patients at the same time. It is elementary and obvious. 

And the political argument for 7 day NHS has little to do with demographic change. Health services can be provided to a larger population in precisely the same way it is now, although you will need more premises and staff. More people don't drive a need for displacement of activity to weekends and out of hours. 

In any case we already have a 7 day NHS, and have had once since the NHS was founded. That is for emergency need, although if you are ever in an A&E on a Saturday night you will see many which are far from emergencies. What you are presumably arguing for, although I am not sure you even know what you mean, is a full routine and elective service running at weekend, 24/7 or something. I don't think you really understand the implications of either one. Unless there is a large expansion in staff, and there is no money for that, then the best you can do is displace activity from weekdays to weekends. Then next time you ring the GP surgery, it will be 4 weeks for that appointment instead of 3. The cost for that full 7 day service is tens of billions. 

The NHS is a supply based system, not a demand based one (like in the US). Demand in healthcare is different from demand in whatever market you work in. Many of the people who demand healthcare don't actually need it, or don't need it right away. It is amazing how many minor niggles go away when you ask people to wait a few days or weeks. Giving funds on the basis of demand is a recipe for uncontrolled and uncontrollable cost inflation, like they have in the US, where they pay twice as much for somewhat less actual healthcare. You simply can't rely on people's good sense because many don't have any.
		
Click to expand...

This^^^

Anyway - NHS Scotland is short of doctors and GPs - and as NHS Scotland is quite separate from NHS (England) -  though in his pronouncements I am not sure Hunt remembers this - and there is less appetite in the Scottish government for what Hunt wants.  So maybe then if things come to pass in England as Hunt intends a good number of doctors in England will look to move to Scotland.


----------



## HomerJSimpson (Nov 7, 2015)

MegaSteve said:



			I am sure the good residents of Gatwick and Stansted will be more than happy to see an extra runway built in their locality... Brings great benefits to the area [apparently]....
		
Click to expand...

There will never be an answer to please anyone in the locality of the chose airport. I think we can all understand their issues. However, clearly there's obviously an increasing demand and something has to be done. Not sure where or when and can see legal ramblings dragging along for many a year to come


----------



## delc (Nov 7, 2015)

HomerJSimpson said:



			There will never be an answer to please anyone in the locality of the chose airport. I think we can all understand their issues. However, clearly there's obviously an increasing demand and something has to be done. Not sure where or when and can see legal ramblings dragging along for many a year to come
		
Click to expand...

An extra runway at Heathrow involves either completely demolishing the town of Sipson, when we need more housing in the area, not less, or doubling the length of one of the existing runways (with separate arrival and departure sections), in which case an underpass will have to be built to take the M25!


----------



## Liverpoolphil (Nov 7, 2015)

delc said:



			An extra runway at Heathrow involves either completely demolishing the town of Sipson, when we need more housing in the area, not less, or doubling the length of one of the existing runways (with separate arrival and departure sections), in which case an underpass will have to be built to take the M25!
		
Click to expand...

If it helps the country progress then surely there is no issue :thup:


----------



## HomerJSimpson (Nov 7, 2015)

Liverpoolphil said:



			If it helps the country progress then surely there is no issue :thup:
		
Click to expand...

Of course it is. Same as there are issues with Gatwick and Stanstead and why these have to be looked at pragmatically and for a long term outcome and not a quick fix for now and some easy bucks for those involved


----------



## Hobbit (Nov 7, 2015)

SwingsitlikeHogan said:



			This^^^

Anyway - NHS Scotland is short of doctors and GPs - and as NHS Scotland is quite separate from NHS (England) -  though in his pronouncements I am not sure Hunt remembers this - and there is less appetite in the Scottish government for what Hunt wants.  So maybe then if things come to pass in England as Hunt intends a good number of doctors in England will look to move to Scotland.
		
Click to expand...

"This" what?!?

You seem to want the NHS to continues as is. How on earth will that sort out the ever increasing waiting lists? If you keep doing the same thing, then you will keep getting the same results. Something needs to change. An ever increasing population being crammed into the same size NHS. It just doesn't work.

Depending on the condition, i.e. recovery could be at home, bring them in to Outpatients/Day Surgery on a Saturday/Sunday. Yes, more staff/funding is required.

All we seem to see at present is healthcare professionals saying no and JH saying yes. Its pathetic! And the people suffering, whilst all the posturing is going on, is the patients. When will someone put forward a workable solution?


----------



## delc (Nov 7, 2015)

Hobbit said:



			"This" what?!?

You seem to want the NHS to continues as is. How on earth will that sort out the ever increasing waiting lists? If you keep doing the same thing, then you will keep getting the same results. Something needs to change. An ever increasing population being crammed into the same size NHS. It just doesn't work.

Depending on the condition, i.e. recovery could be at home, bring them in to Outpatients/Day Surgery on a Saturday/Sunday. Yes, more staff/funding is required.

All we seem to see at present is healthcare professionals saying no and JH saying yes. Its pathetic! And the people suffering, whilst all the posturing is going on, is the patients. When will someone put forward a workable solution?
		
Click to expand...

The NHS seems to be beset with bureaucracy and form filling, rather than actually treating patients. Surely this could be simplified?


----------



## Sweep (Nov 8, 2015)

Ethan said:



			I am sorry, but you are wrong. Time stolen from clinical contact time has everything to do with the increasing demands and reducing availability in the NHS. If doctors are filling in useless forms, they are not seeing patients at the same time. It is elementary and obvious. 

And the political argument for 7 day NHS has little to do with demographic change. Health services can be provided to a larger population in precisely the same way it is now, although you will need more premises and staff. More people don't drive a need for displacement of activity to weekends and out of hours. 

In any case we already have a 7 day NHS, and have had once since the NHS was founded. That is for emergency need, although if you are ever in an A&E on a Saturday night you will see many which are far from emergencies. What you are presumably arguing for, although I am not sure you even know what you mean, is a full routine and elective service running at weekend, 24/7 or something. I don't think you really understand the implications of either one. Unless there is a large expansion in staff, and there is no money for that, then the best you can do is displace activity from weekdays to weekends. Then next time you ring the GP surgery, it will be 4 weeks for that appointment instead of 3. The cost for that full 7 day service is tens of billions. 

The NHS is a supply based system, not a demand based one (like in the US). Demand in healthcare is different from demand in whatever market you work in. Many of the people who demand healthcare don't actually need it, or don't need it right away. It is amazing how many minor niggles go away when you ask people to wait a few days or weeks. Giving funds on the basis of demand is a recipe for uncontrolled and uncontrollable cost inflation, like they have in the US, where they pay twice as much for somewhat less actual healthcare. You simply can't rely on people's good sense because many don't have any.
		
Click to expand...

I am sorry, but where did I say that time taken from clinical contract time has nothing to do with increasing demands and availability??? I agreed with you that the NHS could be run better and that the money could be better spent. What I said was that the case for a 7 day NHS is separate from the way it is run.
I am not sure what you mean when you say its a supply based system rather than demand based, but it should be demand based. I absolutely agree that the surgeries are full of people trying to get a sick note and old people coming in for a warm. I have seen it myself, they wear a prescription like a badge if honour, but all that is a separate issue and needs to be dealt with separately. It's a poor excuse to use for offering a poorer service than possible for those who need it. Again, the NHS just needs to ask itself, how would it operate if it was charging money not spending it? Then it would provide the service we need and deserve. 
Too much of this argument is based around the people who work in the NHS and not about the people who pay for it. An ex colleague of mine retired and did some work in the NHS for a charity. He told me he was shocked about the culture, saying that the main conversation in breaks was how quickly after 50 they can retire on big pensions (probably not as big now) and how quickly they can come back and earn their wage again whilst still drawing said pension. You have to face facts. This could never happen in the private sector and that's because companies who operated such policies would fail. The NHS and other public services need to adopt similar cultures in all aspects of their business, including personnel and service.
So if you say the NHS has no issue with coping with demographic change and can do so without a 7 day service, how come it can't cope now? How come people are dying on waiting lists? How come it takes 3 weeks just to see your GP?  So it's all OK then? We just carry on as we are?


----------



## SwingsitlikeHogan (Nov 8, 2015)

SwingsitlikeHogan said:



*This^^^*

Anyway - NHS Scotland is short of doctors and GPs - and as NHS Scotland is quite separate from NHS (England) -  though in his pronouncements I am not sure Hunt remembers this - and there is less appetite in the Scottish government for what Hunt wants.  So maybe then if things come to pass in England as Hunt intends a good number of doctors in England will look to move to Scotland.
		
Click to expand...

*Agreeing with what was quoted above* I think is the way of it.  

You change it if it needs changing and what you change doesn't break what is already there.  The NHS is very far from perfect - but is a 7-day NHS the #1 priority?


----------



## SwingsitlikeHogan (Nov 8, 2015)

And I read today Osborne won't abandon his aspirations for Tax Credit - whatever anyone in his party says - irrespective of what the electorate might think and say - as a U-turn would damage his ambitions to be PM.  That's OK then.


----------



## SwingsitlikeHogan (Nov 8, 2015)

Sweep said:



			I am sorry, but where did I say that time taken from clinical contract time has nothing to do with increasing demands and availability??? I agreed with you that the NHS could be run better and that the money could be better spent. What I said was that the case for a 7 day NHS is separate from the way it is run.
I am not sure what you mean when you say its a supply based system rather than demand based, but it should be demand based. I absolutely agree that the surgeries are full of people trying to get a sick note and old people coming in for a warm. I have seen it myself, they wear a prescription like a badge if honour, but all that is a separate issue and needs to be dealt with separately. It's a poor excuse to use for offering a poorer service than possible for those who need it. Again, the NHS just needs to ask itself, how would it operate if it was charging money not spending it? Then it would provide the service we need and deserve. 
Too much of this argument is based around the people who work in the NHS and not about the people who pay for it. An ex colleague of mine retired and did some work in the NHS for a charity. He told me he was shocked about the culture, saying that the main conversation in breaks was *how quickly after 50 they can retire on big pensions (probably not as big now) and how quickly they can come back and earn their wage again whilst still drawing said pension.* You have to face facts. This could never happen in the private sector and that's because companies who operated such policies would fail. The NHS and other public services need to adopt similar cultures in all aspects of their business, including personnel and service.
So if you say the NHS has no issue with coping with demographic change and can do so without a 7 day service, how come it can't cope now? How come people are dying on waiting lists? How come it takes 3 weeks just to see your GP?  So it's all OK then? We just carry on as we are?
		
Click to expand...

In being critical of *this * you need to understand how it works - it's not quite as simple and commonplace as your friend suggests.  And your friend might ask *why* some NHS staff are looking to do what he describes.  Well I'll tell you - they are demoralised, fed up and knackered.


----------



## Hobbit (Nov 8, 2015)

SwingsitlikeHogan said:



			In being critical of *this * you need to understand how it works - it's not quite as simple and commonplace as your friend suggests.  And your friend might ask *why* some NHS staff are looking to do what he describes.  Well I'll tell you - they are demoralised, fed up and knackered.
		
Click to expand...

No one forces them to stay.

During the last 6 years we've had a lot of dealings with the NHS. There's some great people in the NHS but, equally, there's some absolute rubbish. The Acute Care areas are as good as you'll find anywhere in the world. However, the general wards are a disgrace. To quote the German Doctor I shared a flat with whilst still in the NHS, "your hospitals are very good but I'm going back to Germany when I get old. Your elderly care in non-existent. You reach a certain age, and then you are forgotten." The last 6 years of mum's life have certainly confirmed that.

Its not just the mess the politicians have made of it. There's a number of staff that need sacking! They might well be fed up and demoralised, but there's no need to take out their woes on the patients.


----------



## SwingsitlikeHogan (Nov 8, 2015)

Hobbit said:



			No one forces them to stay.

During the last 6 years we've had a lot of dealings with the NHS. There's some great people in the NHS but, equally, there's some absolute rubbish. The Acute Care areas are as good as you'll find anywhere in the world. However, the general wards are a disgrace. To quote the German Doctor I shared a flat with whilst still in the NHS, "your hospitals are very good but I'm going back to Germany when I get old. Your elderly care in non-existent. You reach a certain age, and then you are forgotten." The last 6 years of mum's life have certainly confirmed that.

Its not just the mess the politicians have made of it. There's a number of staff that need sacking! They might well be fed up and demoralised, but there's no need to take out their woes on the patients.
		
Click to expand...

I can certainly agree with some of your comments about some NHS staff - my wife's job is difficult and very stressful at the moment because of difficulties in the team she works in - in may ways some of them are more concerned about themselves than delivering the service - one especially seems to be going out of her way to disrupt and undermine the moral of the whole team.  But try and get rid of that individual...unbelievable.

And because of this my wife will be one who will look to finish her current job in the next couple of years; take her lump sum and start taking her pension.  She will probably also apply for another post in the unit, working maybe 2 or 3 days a week - that is if there are any posts for her to apply for.  Has she earned the right to finish in her mid-50s and do this? - damn right she does - she has worked all her life in the NHS and given a huge amount to it without a huge amount in return.


----------



## HomerJSimpson (Nov 8, 2015)

SwingsitlikeHogan said:



			I can certainly agree with some of your comments about some NHS staff - my wife's job is difficult and very stressful at the moment because of difficulties in the team she works in - in may ways some of them are more concerned about themselves than delivering the service - one especially seems to be going out of her way to disrupt and undermine the moral of the whole team.  But try and get rid of that individual...unbelievable.

And because of this my wife will be one who will look to finish her current job in the next couple of years; take her lump sum and start taking her pension.  She will probably also apply for another post in the unit, working maybe 2 or 3 days a week - that is if there are any posts for her to apply for.  Has she earned the right to finish in her mid-50s and do this? - damn right she does - she has worked all her life in the NHS and given a huge amount to it without a huge amount in return.
		
Click to expand...

I sympathise with your wife and sadly the job and the whole publicity regarding the NHS right now is making the job of trying to recruit staff particularly hard. Clearly we don't want just anyone and so ensuring as best as possible before appointment that we have the right nurse or other staff for the job takes some work. Of course it could perhaps be streamlined (we have just gone through a major restructuring) but it's hard to get people in the door quick enough. If we don't agency spend continues to rise, sucking money that could be used elsewhere. 

Sadly there probably isn't an answer at this juncture of NHS history. What I would like to remind even the most hardened though is that you still have a wonderful *free* service available to you and irrespective of what you think and how you may find them I'd say 95% of the staff you deal with are doing their best to give as good a service as they can amidst a host of financial and political constraints


----------



## Hobbit (Nov 8, 2015)

HomerJSimpson said:



			Sadly there probably isn't an answer at this juncture of NHS history. What I would like to remind even the most hardened though is that you still have a wonderful *free* service available to you and irrespective of what you think and how you may find them I'd say 95% of the staff you deal with are doing their best to give as good a service as they can amidst a host of financial and political constraints
		
Click to expand...

I'd say 99% of staff in the Acute Care areas are worth far more than they are paid. In the main, they are highly trained and highly motivated. However, if you think 95% of staff elsewhere are doing their best... lazy and uncaring doesn't come close. On the last ward mum was on the Ward Sister and 1 nurse were excellent, but after that.

As for we should be grateful because its free. Its *not* free! Who do you think pays for it, the tooth fairy? It doesn't matter whether its free or not but it does matter if its fit for purpose.


----------



## HomerJSimpson (Nov 8, 2015)

Hobbit said:



			I'd say 99% of staff in the Acute Care areas are worth far more than they are paid. In the main, they are highly trained and highly motivated. However, if you think 95% of staff elsewhere are doing their best... lazy and uncaring doesn't come close. On the last ward mum was on the Ward Sister and 1 nurse were excellent, but after that.

As for we should be grateful because its free. Its *not* free! Who do you think pays for it, the tooth fairy? It doesn't matter whether its free or not but it does matter if its fit for purpose.
		
Click to expand...

OK, so how many of those nurses were staff nad how many were agency. I would suggest quite a few as sadly in areas like respiratory, gastro, elderly etc (basically the totally necessary but unglamorous areas) there is a lot of shortages, certainly in my trust and not through lack of trying.

As for "free" of course I accept it isn't in the true sense of the word but still a use as required service and one which I, and my family are very pleased has been there


----------



## Hobbit (Nov 8, 2015)

HomerJSimpson said:



			OK, so how many of those nurses were staff nad how many were agency. I would suggest quite a few as sadly in areas like respiratory, gastro, elderly etc (basically the totally necessary but unglamorous areas) there is a lot of shortages, certainly in my trust and not through lack of trying.

As for "free" of course I accept it isn't in the true sense of the word but still a use as required service and one which I, and my family are very pleased has been there
		
Click to expand...

If they're agency, who's responsible for employing them and who's responsible for managing them? That's a cop out and you know it.


----------



## HomerJSimpson (Nov 8, 2015)

Hobbit said:



			If they're agency, who's responsible for employing them and who's responsible for managing them? That's a cop out and you know it.
		
Click to expand...

How? If wards aren't safely staffed they have to close. You'll find that they are employed via agencies and bed management and managed by the ward sister. Not sure how it's a cop out


----------



## Hobbit (Nov 8, 2015)

HomerJSimpson said:



			How? If wards aren't safely staffed they have to close. You'll find that they are employed via agencies and bed management and managed by the ward sister. Not sure how it's a cop out
		
Click to expand...

You're making an assumption "its not us. We're squeaky clean its them." = Cop out. You are attempting to distance the NHS from them without any facts to base it on. And the NHS is responsible for employing them and managing them on the ward. Put another way, if there is a clinical incident, who gets sued? Is it the Trust or the agency? Responsible for them includes their performance...


----------



## Sweep (Nov 9, 2015)

SwingsitlikeHogan said:



			And because of this my wife will be one who will look to finish her current job in the next couple of years; take her lump sum and start taking her pension.  She will probably also apply for another post in the unit, working maybe 2 or 3 days a week - that is if there are any posts for her to apply for.  Has she earned the right to finish in her mid-50s and do this? - damn right she does - she has worked all her life in the NHS and given a huge amount to it without a huge amount in return.
		
Click to expand...

Really? What right is that? I have worked in my industry all my life, since before I left school if you count day release, 40 years full time. Can I retire in my mid 50's? Can I take my lump sum and just go back to work? Absolutely not. Why? Because I work in the the real world otherwise known as the private sector, where it's understood you just can't do those kinds of things and survive. But somehow it's OK in the NHS because it's public money and the money they get comes in whether they perform well or not. Funny. In an earlier post someone said in the private sector they look after their staff, but the NHS treats theirs disgracefully. Sorry, but it doesn't seem like that to me. I am not surprised the NHS are moaning about 7 day. Considering no-one past mid 50's is working full time there won't be enough staff and as they have all taken their lump sum, it's not surprising there isn't enough money. It's this kind of culture that put Greece in trouble.


----------



## Sweep (Nov 9, 2015)

Sorry, just re-read my last post and realised it may come across as me having a go at your wife, which absolutely wasn't my intention. It was the system that allows this I was arguing against.


----------



## SwingsitlikeHogan (Nov 9, 2015)

Sweep said:



			Sorry, just re-read my last post and realised it may come across as me having a go at your wife, which absolutely wasn't my intention. It was the system that allows this I was arguing against.
		
Click to expand...

It's nothing to so with the NHS 'system'.  ANYONE can start drawing their pension when they are entitled to and then seek further employment.  That is all that NHS staff who are able to start drawing their 'pension' are doing - resigning from their current job and applying for another one in the same organisation - but they could apply for a job anywhere.  Besides - there is absolutely no guarantee of a job in the NHS being available for them to apply for once they have resigned from their current one (as they must do to start taking their 'pension').  

(btw Osborne's changes to pension schemes make it obvious now that pension schemes are actually now long term saving schemes and not linked in any way to 'retiring')


----------



## Deleted member 16999 (Nov 9, 2015)

SwingsitlikeHogan said:



			It's nothing to so with the NHS 'system'.  ANYONE can start drawing their pension when they are entitled to and then seek further employment.  That is all that NHS staff who are able to start drawing their 'pension' are doing - resigning from their current job and applying for another one in the same organisation - but they could apply for a job anywhere.  Besides - there is absolutely no guarantee of a job in the NHS being available for them to apply for once they have resigned from their current one (as they must do to start taking their 'pension').  

(btw Osborne's changes to pension schemes make it obvious now that pension schemes are actually now long term saving schemes and not linked in any way to 'retiring')
		
Click to expand...

You can't in the Forces, your future wage is abated by your pension so you end up on the same money, it's treasurey rules, same as a policeman etc


----------



## SwingsitlikeHogan (Nov 9, 2015)

pauldj42 said:



			You can't in the Forces, your future wage is abated by your pension so you end up on the same money, it's treasurey rules, same as a policeman etc
		
Click to expand...

Same rules apply for the NHS Pension Scheme.  You cannot earn more 'pension' plus salary then your previous full time salary.  This is one reason why the likes of my wife will see if there is a part-time 2-3 day position.  

Actually the main reason she will look for a part-time position that she has decided she doesn't want to keep working full time.  Mind you - the situation in her NHS team and the broader NHS is such that she's not sure that she wants to continue working in it anyway.  And that is a big issue for the NHS as many thousands of very experienced nurses like my missis (she has over 35yrs in the NHS) are considering jacking it in completely and it is that age group that in many ways are currently holding the NHS together.

I know that without my missis absolutely busting a gut over the last two years and going way beyond the call of duty as others in her team have been off work with long term sickness, anxiety, stress etc - the service her team delivers would have been a mess.  And she has had it - it's almost burnt her out.


----------



## delc (Nov 9, 2015)

The fact of the matter is that the UK, no longer having an empire to exploit, is slowly becoming a Third World country, whichever political party is in power. Things like the NHS and Tax Credits are very desirable, but do we have the means to pay for them any more? We are in some danger of ending up like Greece!


----------



## Hobbit (Nov 9, 2015)

SwingsitlikeHogan said:



			I know that without my missis absolutely busting a gut over the last two years and going way beyond the call of duty as others in her team have been off work with long term sickness, anxiety, stress etc - the service her team delivers would have been a mess.  And she has had it - it's almost burnt her out.
		
Click to expand...

And one of the reasons why I left the NHS. Staff discussing whose turn it was for time off sick on full pay, and who was close to their 6 months off sick... people running a rota for sick holidays. And laziness! Crikey, it was a social club for some. Some were good grafters and some just took the pee. I got a gentle roasting from a senior engineer for spoiling the overtime by getting through so much maintenance work through the week. A minority but, as you said in an earlier post, quite often the management haven't got the guts to do something about it.


----------



## bluewolf (Nov 9, 2015)

Hobbit said:



			And one of the reasons why I left the NHS. Staff discussing whose turn it was for time off sick on full pay, and who was close to their 6 months off sick... people running a rota for sick holidays. And laziness! Crikey, it was a social club for some. Some were good grafters and some just took the pee. I got a gentle roasting from a senior engineer for spoiling the overtime by getting through so much maintenance work through the week. A minority but, as you said in an earlier post, quite often the management haven't got the guts to do something about it.
		
Click to expand...

I'm not really interested in the wider debate, but what you've described there is not solely the preserve of the NHS. It's anywhere with a decent sick scheme.. My old employer provided a great sick scheme, and people abused it.. We had what was called "The Bro*****n fortnight" (not swearing, just don't want to mention the name of my ex employer). It was better to take 2 weeks off than it was to take 2 days off. It was expected, and you'd get abuse if you didn't take it.. Rota'd sickness, etc etc..

What you are describing is a minority of people who will attempt to take advantage of every facet of a contract, whomever they work for.. To level the complaint at the NHS is a bit unfair really..


----------



## SwingsitlikeHogan (Nov 9, 2015)

Hobbit said:



			And one of the reasons why I left the NHS. Staff discussing whose turn it was for time off sick on full pay, and who was close to their 6 months off sick... people running a rota for sick holidays. And laziness! Crikey, it was a social club for some. Some were good grafters and some just took the pee. I got a gentle roasting from a senior engineer for spoiling the overtime by getting through so much maintenance work through the week. *A minority but, as you said in an earlier post, quite often the management haven't got the guts to do something about it*.
		
Click to expand...

I can wholeheartedly agree on that.  But sometimes they just feel that they don't have the authority to manage.  One of my wife's team has been signed off off by her GP for stress and anxiety - when in fact what has happened is that she has had disagreements over procedure with her immediately working colleague - it almost farcically funny - if it didn't load more work on the other three in the team for as long as she is off...


----------



## SwingsitlikeHogan (Nov 9, 2015)

Anyway - will Osborne walk away from Tax Credit changes in the face of all the evidence presented that show how damaging it will be - and that he has got his sums wrong.  Or will his vanity, pride and ambition cause him to carry on regardless.  Does he actually care about what the electorate who voted Conservative, and hence for tax credit cuts as defined in the Tory manifesto (except they weren't), now think about these cuts?


----------



## bluewolf (Nov 9, 2015)

SwingsitlikeHogan said:



			Anyway - will Osborne walk away from Tax Credit changes in the face of all the evidence presented that show how damaging it will be - and that he has got his sums wrong.  Or will his vanity, pride and ambition cause him to carry on regardless.  Does he actually care about what the electorate who voted Conservative, and hence for tax credit cuts as defined in the Tory manifesto (except they weren't), now think about these cuts?
		
Click to expand...

He'll push ahead with Tax Credit cuts.. It's a Conservative ethos to reduce the welfare state, then rely on tax cuts to stimulate economic growth and therefore job creation.. This will then pull everyone back into work and negate the reduction of the welfare dismemberment......

Unfortunately, this doesn't really work as it fails to take into account any sort of automation in the workplace.. What tends to happen is that the tax cuts are gleefully accepted by the 1%. They then use this "bonus" to retool the shopfloor and remove even more staff from the wage bill, therefore throwing even more people into a system that has already been taken apart..

In effect, it serves to hasten the entropy of a fully capitalist state.. Whether we like it or not, both sides of the debate require each other to balance out the failures in our own preferred system... This a bit of a simplistic view really, but I like simple..


----------



## delc (Nov 9, 2015)

Isn't one of problems politicians who promise the Earth to get elected, but then fail to deliver the goods afterwards?  We are always being promised jam tomorrow, but tomorrow never seems to arrive!


----------



## SwingsitlikeHogan (Nov 9, 2015)

delc said:



			Isn't one of problems politicians who promise the Earth to get elected, but then fail to deliver the goods afterwards?  We are always being promised jam tomorrow, but tomorrow never seems to arrive!
		
Click to expand...

Osborne seems hell bent on providing the jam to some whilst taking away the bread from others.  Thing is that many who gave Osborne the mandate to do what he is doing - didn;t realise that he do it to them - certainly not to the extent he's going to.  Would they be upset if he 'failed' to deliver tax credit cuts?  I don't think so.  Be clear about the reasoning why he's not going to do it and I don't think he'll be too damaged - it might actually improve his image


----------



## delc (Nov 9, 2015)

SwingsitlikeHogan said:



			Osborne seems hell bent on providing the jam to some whilst taking away the bread from others.  Thing is that many who gave Osborne the mandate to do what he is doing - didn;t realise that he do it to them - certainly not to the extent he's going to.  Would they be upset if he 'failed' to deliver tax credit cuts?  I don't think so.  Be clear about the reasoning why he's not going to do it and I don't think he'll be too damaged - it might actually improve his image
		
Click to expand...

If Osbourne does cut Tax Credits, there will have to be some people who become worse off, unless we can get full employment with decent rates of pay for all (fairly unlikely!).  I note that Dave Cameron would not admit this when pressed by Jeremy Corbyn on the issue!


----------

