Ed Miliband and the Labour Party

[Foxholer]

@Ethan

The latest economic crisis was always going to hit UK - along with the rest of the (Western) world! Labour were exposed (both meanings of that word) because they were in power at the time.

PFI in UK was begun by the Conservatives. It can/should be a way of optimising risk and capital (both government and private) for major projects. There are examples where it has worked, and is working extremely well - from both sides points of views. The biggest issue/fault PFIs had was that they were 'off balance sheet', an area Gordon Brown was keen to exploit!

NHS is a bottomless pit for expenditure! However much improvement is made by throwing money at deserving areas, there will always be a demand to throw even more money at it. The 'queue-jumping' that is available to private clients - involving the same teams and facilities - clearly demonstrates that there is a funding need! I believe PFI is appropriate for building hospitals. Any creeping privatisation of NHS should be resisted, though, generally, medical/clinical staff should employed for medical/clinical work, not management ones so 'outsiders' should be encouraged to manage medical facilities.

 

[Doon frae Troon]

So policy for the UK as a whole is to be controlled by a party representing one very small part of the country, which, by the way, they don't wish to be part of.

You are always bleating about Scotland being under represented (despite having more MP's per capita than England) and yet you seem happy about this.

More double standards and hypocrisy!

Boots on the other foot for a change.........not nice is it.

Read your first sentence again, How can a small party control, influence perhaps, not control.

 

[Deleted member 18588]

Boots on the other foot for a change.........not nice is it.

Read your first sentence again, How can a small party control, influence perhaps, not control.

So, as I thought, a complete hypocrite or do two wrongs make a right.

Having listened to Ms Sturgeon on last night's news programme she certainly did not appear to be someone likely to be satisfied with mere influence rather than control.

 

[CMAC]

It seems the are moves to get him out , they are behind in the ratings so want a change . His image to the public is not at its highest at the moment and if you look back in history you will see a Michael Foot up against Mrs Thatcher , only ever going to be one winner as even if he was a good MP he did not appeal to the voters . since then there has always been and image thing and Tony Blair fitted that to the tee , I am not talking about policies just image . will there be a change if so who ? Do you think it matters at all , I think it does

do you, and the rest of the posters baying for his blood, realise that it's only a few newspapers and the BBC who have portrayed him this way- there is not one piece of tangible evidence from anyone prepared to go on record saying this (correct as of last night in case anythings popped up today)

 

[Ethan]

@Ethan

The latest economic crisis was always going to hit UK - along with the rest of the (Western) world! Labour were exposed (both meanings of that word) because they were in power at the time.

PFI in UK was begun by the Conservatives. It can/should be a way of optimising risk and capital (both government and private) for major projects. There are examples where it has worked, and is working extremely well - from both sides points of views. The biggest issue/fault PFIs had was that they were 'off balance sheet', an area Gordon Brown was keen to exploit!

NHS is a bottomless pit for expenditure! However much improvement is made by throwing money at deserving areas, there will always be a demand to throw even more money at it. The 'queue-jumping' that is available to private clients - involving the same teams and facilities - clearly demonstrates that there is a funding need! I believe PFI is appropriate for building hospitals. Any creeping privatisation of NHS should be resisted, though, generally, medical/clinical staff should employed for medical/clinical work, not management ones so 'outsiders' should be encouraged to manage medical facilities.

PFI was indeed begun by the Tories, but really took off in 1997 when New Labour wanted to prove they were pro-business and the city. Conceptually PFI might be OK, although that is questionable, but in practice the DH has negotiated NHS PFI deals so badly that they have turned out to be punitively expensive with famous examples such as the £100 light bulb and many terrible service contracts. Early PFI deals were immediately flipped for large profits and Trusts are going bust trying to service them.

 

[Foxholer]

PFI was indeed begun by the Tories, but really took off in 1997 when New Labour wanted to prove they were pro-business and the city. Conceptually PFI might be OK, although that is questionable, but in practice the DH has negotiated NHS PFI deals so badly that they have turned out to be punitively expensive with famous examples such as the £100 light bulb and many terrible service contracts. Early PFI deals were immediately flipped for large profits and Trusts are going bust trying to service them.

That's the REAL problem with them! It's not the initial contract, though typically the cost of inevitable changes is exorbitant - I believe some sort of contingency for minor changes should be included in the contract, returning to government if not used (that never happens, but it does mean that the 'finished' project is more likely to be fit for purpose). Unjustified charges should mean that the contractor gets hit even more-so! And while I posted 'PFI fine for Capital Works', I merely implied my view that it is an extremely poor vehicle for Service type activities! It was only Broon's enthusiasm for 'off Book' expenditure that made it popular imo!

 

[Deleted member 18588]

PFI was indeed begun by the Tories, but really took off in 1997 when New Labour wanted to prove they were pro-business and the city. Conceptually PFI might be OK, although that is questionable, but in practice the DH has negotiated NHS PFI deals so badly that they have turned out to be punitively expensive with famous examples such as the £100 light bulb and many terrible service contracts. Early PFI deals were immediately flipped for large profits and Trusts are going bust trying to service them.

But surely that is the fault of NHS management rather than the concept and those same managers are likely to make a mess of funding resources from wherever it arises.

Obviously it is not scientific research but over the last 15 years I have seen the insides of hospitals as an in and outpatient as well as visiting family rather more than I would like. The one constant observation is that whilst there may on occasions have been a shortage of medical staff there always seems to be plenty of clip-board carrying admin staff and managers.

Similarly the number of staff attending meetings and conferences in London seems designed to keep the rail companies in business.

A first class public medical service that the professionals wish to deliver requires much better management from the Minister right down to local level. I don't think this is currently the case.

 

[SocketRocket]

Current funding of services like the NHS are unsustainable and driving the National Debt to levels where the interest payments are larger than defence spending.

Some suggest that Governments need to consider what their role should be. Should they try to provide services that can be provided adequately by the private sector at lower costs with similar or even better results. Canada went through such a process and emerged very well from it.

I know many will think such a policy unimaginable but when needs must we should consider all possibilities, the country going bankrupt being one of them.

Whichever group form a Government next year they will be faced with cutting expenditure to an extent we have not seen yet.

 

[Tashyboy]

Strange how people now think that you could not put a fag paper between labour and the Torys.

me dad said that during the first few weeks of the miners strike in 1984, how I laughed. Not quite sure when it was I stopped laughing at the realisation he was right.

re ed and the Labour Party. Yawn. He just comes across as having no personality what so ever, and he's not the only one.

. Open question coz I don't know the answer. Why was ed voted as leader of the party and not his brother.

What i do know is that with Blair now knocking about on the fringes it is doing Labour no good whatsoever. People have still not forgot his legacy.
Problem is as well whilst taking about legacys, is that whether people want to talk about immigration or not. It is a massive issue to a lot of people and the same people see labour as the main instigators of it, so how can they be believed when it comes to trying to rectify it. It could also be said that the Torys have not exactly pulled there fingers out, but at least they are finally putting out some kind of response. An interesting political 7 months me finks.

 

[Tashyboy]

Re funding of the NHS, having spoken to Missis tash, getting rid of a lot of management and making them more accountable for a start would help.

accountability of purchasing overpriced equipment and drugs.

 

[Doon frae Troon]

. Open question coz I don't know the answer. Why was ed voted as leader of the party and not his brother.

What i do know is that with Blair now knocking about on the fringes it is doing Labour no good whatsoever. People have still not forgot his legacy.
Problem is as well whilst taking about legacys, is that whether people want to talk about immigration or not. It is a massive issue to a lot of people and the same people see labour as the main instigators of it, so how can they be believed when it comes to trying to rectify it. It could also be said that the Torys have not exactly pulled there fingers out, but at least they are finally putting out some kind of response. An interesting political 7 months me finks.

I think it was with Union support, the same people who gave us Foot and Kinnock.

They finally got it right with John Smith who sadly died far too young. If ever a man was missed it was him.

 

[Foxholer]

Re funding of the NHS, having spoken to Missis tash, getting rid of a lot of management and making them more accountable for a start would help.

accountability of purchasing overpriced equipment and drugs.

The problem/challenge I see with this is that it has to be 'target based' which really doesn't work properly in an organisation like a Hospital, except in specific areas.

Supposedly 'overpriced' equipment may fulfill a serious need - and both need and usage can be measured. Drug cost/benefit value is actually undertaken by NICE.

 

[Ethan]

The problem/challenge I see with this is that it has to be 'target based' which really doesn't work properly in an organisation like a Hospital, except in specific areas.

Supposedly 'overpriced' equipment may fulfill a serious need - and both need and usage can be measured. Drug cost/benefit value is actually undertaken by NICE.

NICE is just a pseudo-scientific veneer for crude rationing decisions. Their methodology revolves all around the assumptions (or prejudices) of the health economists commissioned by NICE. The NICE process also does not take into account other systems for capping the medicines budget like the PPRS, which limits how much companies can take in the UK.

Anyway, the issue with the NHS is political. Politicians who set up the ludicrous Trust system which have pretended to give local accountability but instead has massively increased bureaucracy, corporate structures and transaction costs as well as political targets such as the 2 week wait for cancer diagnoses, the 4 hour A&E waiting time and many others. These sound reasonable things to do, but they distort the system and lots of parts of the NHS game them. The same politicians also raise expectations among the public at the same time as they show their contempt for the people who work in the NHS. That is a bad combination. One would almost think they are trying to force a crisis for which the best solution is entry of private companies to take over Trusts and staff contracts.

 

[Foxholer]

NICE is just a pseudo-scientific veneer for crude rationing decisions. Their methodology revolves all around the assumptions (or prejudices) of the health economists commissioned by NICE. The NICE process also does not take into account other systems for capping the medicines budget like the PPRS, which limits how much companies can take in the UK.

I'm pretty sure you are correct - and you are certainly better placed than I am to know! But my point was that that the cost of drugs wasn't something that individual NHS units needed to be specifically accountable for - though 'excessive' use of expensive drugs might be something to be justified.

Anyway, the issue with the NHS is political. Politicians who set up the ludicrous Trust system which have pretended to give local accountability but instead has massively increased bureaucracy, corporate structures and transaction costs as well as political targets such as the 2 week wait for cancer diagnoses, the 4 hour A&E waiting time and many others. These sound reasonable things to do, but they distort the system and lots of parts of the NHS game them. The same politicians also raise expectations among the public at the same time as they show their contempt for the people who work in the NHS. That is a bad combination. One would almost think they are trying to force a crisis for which the best solution is entry of private companies to take over Trusts and staff contracts.

Pretty much totally agree! Nice intentions, maybe, but doesn't seem to be having the desired effect. Where PFI was/is meant to combine the best aspects of Public/Private combination, Trusts (and any service/non-project activity) can easily combine the 'worst' aspects of them!

 

[Deleted member 18588]

Anyway, the issue with the NHS is political.

No, the issue with the NHS is financial.

Insatiable demand which all Governments have attempted to satisfy with limited supply.

It is not a criticism of the NHS but the difficulties arise as a result of continuous developments in treatments and drugs making it possible to treat conditions that were previously untreatable, also improved lifestyles have led to an ageing population also making demands upon the service.

Three largest Government budgets are, I believe, Health, Welfare and Education. If we are to spend significantly more on Health which of the others do we cut? That is when it becomes political.

 

[Ethan]

No, the issue with the NHS is financial.

Insatiable demand which all Governments have attempted to satisfy with limited supply.

It is not a criticism of the NHS but the difficulties arise as a result of continuous developments in treatments and drugs making it possible to treat conditions that were previously untreatable, also improved lifestyles have led to an ageing population also making demands upon the service.

Three largest Government budgets are, I believe, Health, Welfare and Education. If we are to spend significantly more on Health which of the others do we cut? That is when it becomes political.

The NHS has traditionally been a supply based system - there were so many hospitals, GPs etc and queues determined by priority filtered the cases. Demographics have resulted in an ageing population, but also one which is, on the average, healthier than before. Inflation has occurred in terms of the scope and cost of treatment, and all of these have an effect on the service needs.

But the biggest changes have been through increased expectations, and those are fuelled by politics. Many of the targets and barmy initiatives that currently bog down the NHS are political. I used to be a public health doctor (working in a Health Authority) and these would come across our desks all the time.

People often say demand is insatiable and a bottomless pit. Perhaps in some ways that is true, but it was kept in check for years by gatekeeping in general practice, and limited but adequate supply in secondary care. Now we have a pseudo-market model, that has gone out the window. The NHS has plenty of money but much of it is wasted before it gets to healthcare. On a small scale, that kid who went to Prague for proton-beam therapy is a waste of money, homeopathy hospitals funded by the NHS are a complete waste, much of the apparatus of Trusts and almost all the management consultants are a waste of money, worse still, they generate stuff which wastes other peoples time as well.

Health is a huge drain on every civilised economy. The US spends more than twice (in $) or almost twice ( in terms of % of GDP) as the UK, yet health outcomes are worse overall. The NHS is still pretty efficient overall, but if we stripped it back to a more directly managed service and abandoned a lot of the political fluff, it would be better value still.

 

[Deleted member 18588]

The NHS has traditionally been a supply based system - there were so many hospitals, GPs etc and queues determined by priority filtered the cases. Demographics have resulted in an ageing population, but also one which is, on the average, healthier than before. Inflation has occurred in terms of the scope and cost of treatment, and all of these have an effect on the service needs.

But the biggest changes have been through increased expectations, and those are fuelled by politics. Many of the targets and barmy initiatives that currently bog down the NHS are political. I used to be a public health doctor (working in a Health Authority) and these would come across our desks all the time.

People often say demand is insatiable and a bottomless pit. Perhaps in some ways that is true, but it was kept in check for years by gatekeeping in general practice, and limited but adequate supply in secondary care. Now we have a pseudo-market model, that has gone out the window. The NHS has plenty of money but much of it is wasted before it gets to healthcare. On a small scale, that kid who went to Prague for proton-beam therapy is a waste of money, homeopathy hospitals funded by the NHS are a complete waste, much of the apparatus of Trusts and almost all the management consultants are a waste of money, worse still, they generate stuff which wastes other peoples time as well.

Health is a huge drain on every civilised economy. The US spends more than twice (in $) or almost twice ( in terms of % of GDP) as the UK, yet health outcomes are worse overall. The NHS is still pretty efficient overall, but if we stripped it back to a more directly managed service and abandoned a lot of the political fluff, it would be better value still.

Very interesting since you are clearly well informed by experience.

From your comments the question that arises is which political party, if any, would be prepared to put the genie back in the bottle by managing the public demand and expectations.

The seemingly insatiable demand for resources maybe a problem of a "better informed" society who, via the media etc; hear of various new treatments and therapies which they then, perhaps understandably, expect to be available to them or their families.

One only had to look at the recent case in Southampton where the medical professionals were vilified by some as they were considered to be denying a young boy life saving treatment. Truly a PR nightmare.

So, as I say, which of our politicians is prepared to explain the facts to the electorate?

 

[Tashyboy]

Missis tashyboys role in the in NHS is as a urology outreach nurse. The GPs love her coz she's saves them loads of money, the trust love her coz she makes them tons of money. The patients love her coz they get treated in there own homes and do not spend half a day travelling to and from hospital waiting hours for 30 mins treatment/care. In some cases they cannot get to hospital with out the added cost of expensive transport. Everybody is in a win win win situation.

yet this is where we start to fall out. If it is so fantastic and everyone tells me who is associated with this department that it is, why is it not used as a template for other trusts to use.

she tells me it is the same with GPs surgerys some are fantastic, and the next village along they are well rubbish. How can we get it so wrong within such a small area. Why are the better performing GP surgerys not used as a template for failing surgerys.

fortunately Missis tash says our surgery is one of the best she deals with.:swing:

 

[SocketRocket]

I think that ignoring the growing population as a reason for the NHS being under pressure is avoiding the 'Elephant in the room' Our population has increased by almost 10 million people in a relatively short period and continues to increase at a rate that just has to create pressure on services. We do indeed have an ageing population due to increased post WW2 birth rates but as our population increases at the current level, not only through immigration but high birth rates these people will age and add significantly to the problem.

If I take my local GP group surgery for example: Not long ago it was possible to walk in and see a Doctor within the hour, it is now almost impossible to arrange a future appointment, you are asked to ring in at 8:am to arrange an appointment that day. My experience of this is its pot luck, you ring and just get an engaged tone as everyone is trying to do the same. No wonder people turn up at A&E with minor ailments. Why has this happened, there is actually one more Doctor in the practice, is it due to the NHS barmy initiatives and structures or just overload!

This problem is also there in our schools and demand for housing so whats the answer? Voting in a Labour government, borrowing more money, sacking bureaucrats, pumping up the population further or blaming the Daily Mail!

 

[Doon frae Troon]

http://www.dailyrecord.co.uk/news/politics/poll-bombshell-ed-milliband-shows-4646014

Wow.
When the Mori poll came out a month ago predicting 40 SNP seats the company thought they had made a mucking fuddle and re-ran it.

This lot are predicting up to 52 SNP seats, quite amazing.
2% of those who responded 'trusted' Milliband.