One of the most effective propaganda campaigns ever has been waged on the British public over the last few decades. Conditioned to be permanently angry about the wrong things.
Sounds like he is going to be hammering the NHS tomorrow. Guess most people have had good and bad experience using the system . Often the problems start with the GPs and not getting appointments then all the usual issues with lack of beds etc .
Unfortunately I've had a lot of experience dealing with healthcare and social services over the last 3 years. There's are too many comfortable people in the NHS which puts pressure on the front line staff that actually care and do the important stuff. The communication between people & departments is next to non-existent and if you're in between two boroughs forget it. If anyone has spent time wandering around a hospital after 4pm, on a Friday afternoon or at a weekend you'll know that it's, for many in the NHS a 4 1/2 day a week job. Those working outside those hours then can't do their job as the admin and support staff have ****ed off home. Hospitals need to be 24/7 and I wonder if this new 3 shift policy should be 3 actual shifts rather then bollox they are currently spouting. Having staff doing a 12 hour stint is not ideal, why not have 3 lots of 9 hour shifts, which gives 30min handover periods. If you reduce the dead time (pun intended) during the 24hr day surely you can deal with more patients. If you run 7 days a week you've increased your capacity by 40%. The efficiency is a joke and simply chucking more money at the sytem will not fix it. It needs a complete overhaul which I'm afraid would be political suicide so unlikely. That's not to say there aren't good people in the NHS. They're the people worked to the bone probably not paid enough and holding the current system together. Don't get me started on the council who despite agreeing their systems are wrong, and me having provided them with all the details and data to correct their system, still haven't corrected their care invoices from a year ago. If the overbilling I've experienced is the same for all clients both private and council funded then they've likely been rinsed for Millions. Finding someone who can be arsed to do anything about it has been impossible.
So, in summary NHS staff are too comfortable but also worked to the bone. The admin staff work the hours they are contracted and paid for and they, too, are swamped. Therefore it's not individual inefficiency – or laziness – that's causing the issues it's a lack of willingness to spend what it would cost to have people work longer. Increase spending on admin staff and people would say: "Oh there's loads of waste spent on pen pushers who are doing admin." Well, as it turns out, the admin is pretty critical – unless we want the qualified medical staff to do it instead of treating people. More staff costs more money. Then people will say that 'money is being thrown at it' but the only way to improve it is to accept that healthcare for an ageing population is going to be eye-wateringly expensive and unless you want to pay insurance and take your chances it needs to be funded properly. You only have to look at the buildings so much of the NHS is housed in to see what the real problem is. A complete lack of care and a lack of political and societal will to have anything better. Old, crumbling buildings from the 1960s and 1970s that needed replacing years ago. Go and have a walk round Hemel Hempstead's hospital and see all the 1990s buildings already shuttered up and written off after little over 30 years. The decline in services over the past 14 years is pretty stark. Some would say it's been deliberate. I would challenge you to explain who you think the comfortable people are. What does that actually mean?
There has been a huge explosion in admin in the NHS, partly due to the litigious nature that has invaded our nation, over the last few decades. I'm not necessarily saying that it's a bad thing but the additional costs of making sure all the paperwork work covers the NHS against any liability claims is both costly and time consuming. The NHS managers and admin staff are easy targets when people get angry about the "wasteful" NHS but I know a few people that work "in the background" of the local trust. They work really hard, often doing unpaid hours to try and keep on top of their workload and ensuring paperwork is in order to protect patients, as well as the trust, from costly mistakes. The infrastructure doesn't help, especially the fractured IT systems and crumbling buildings. I don't think there are any easy answers, especially if funding is not increased dramatically. In fact I'll be very surprised if the NHS is "fixed" within Labour's 8 year timescale. But at least they have a plan!
The NHS has substantial indemnity systems. These cost lots of money, but I’m not convinced that is the reason for the increase in admin, as most litigation will be settled before it reaches court. IMO it has more to do with the shift to a quasi-market under Thatcher, which required managers to be in place to ensure targets were met etc.
Obviously this is from my experience and observations. I feel there are underworked overpaid mainly admin and senior staff. There is a core of mainly front-line staff that are underpaid and overworked that are holding the creaking system together. My opinion based on experience, observation and speaking to friends who work in the NHS is that simply chucking money at it without addressing the systems and culture is not going to solve the issues, just kick them down the road further. Yes I agree admin is critical. Why then does it mostly stop at 4pm daily and why is it non-existent after lunch on a Friday and over the weekend? Battling to get someone discharged on a Friday morning because if you don't, you know they'll be rotting in bed with little to no attention over the weekend is enough to make you weep.Being told there's no poitn taking a sample today because it won't be looked at until Monday morning by which time it will have expired, only to be then told there's' no appointments on Monday morning to reshedule. Certainly I agree that funding for the elderly is expensive - given the thousands of pounds I'm currently shelling out a month because my folks don't qualiy for NHS coverage, I know this first hand. There's people making a bundle off of it and the peopel doing the actual caring are paid a pittance. Again it's an systemic issue that chuking money at without change will not fix. Certainly I agree that the buildings need care and investment, the efficiencies and costs of doing the renovations are horrible because it's not managed properly, because of the "comfortable people" not doing a decent job. Many need a kick up the arse many need outright firing. It needs direction and change from government and whilst it's a political football the neccesary changes will never happen. Deliberate decline? maybe not, decline due to government incompetance I would suggest and that's not just the last lot, but the for several governments before that as well. When I refer to comfortable people I mean the sort of person that does the absolute bare minimum. The sort of person that says "That's not my remit" and then does nothing, rather than the sort of person that understands the issue and passes on to the party that can help with it and then follows up to see that the issue is resolved. The sort of person that sits their chatting to their colleague about their holiday, whilst someone is standing in front of them waiting. The sort of person that spends 5 mins on an apointment, does nothingduring that appointment then plays on their phone for 20 mins before driving off to the next appoitnment. The sort of person that has finished their task but choses to ignore that someone else is struggling and could do with an assist. The sort of person that makes a mistake and has the attitude **** happens rather than is mortified, correts the mistake and changes processes so that it won;t happen again. The sort of person that has no incentive if they do a good job, but no penalty if they perfrom poorly. From my recent experinces this is a minor but not an insignificant issue and by no means limited to the NHS. Don't get me started about the DWP, HMRC, social service, the local council.......
Absolutely, there are good people, don;t get me wrong. Succesive governments are squarely to blame for not sorting out the IT systems despite the billions spent. A good example I've been made aware of is a department told they can't deal with patients using the old paper system yet have only been issued 1 electronic device between several people. So the directive was to wait until the first person has finished with the device, log out, log the next person in and deal with the next patient. so despite having 3 staff members available they could only treat 1 person at a time. In this case the department head told the management team that they will continue to use the paper system until there are sufficient devices to switch over to the electronic system.
What are the solutions to all the problems above? Spending more money, attracting and valuing staff by spending more money on them, creating cultures that encourage and inspire people to go the extra yard when necessary. Instead, as a country, we kick and kick and kick the NHS financially and politically. It's underfunded for what people want it to do – which is look after them in their time of need. We demand Rolls-Royce service when we need it, and cornershop bills when we don't. And then, when we actually have to go into a health service facility and we see with our own eyes the state of the facilities and the burden on the people it comes as a shock. Have you ever been to A&E or urgent care or minor injuries or the GP's for that matter, or to go and have a blood test, and not found there's a busy waiting room, a queue and that they are running behind? We spent 3.5hrs in Hemel urgent care on Sunday and none of that delay was because the people working there didn't care. It was because there were too few of them to do the job, and too few x-ray machines for the workload. The staff were unfailingly kind and considerate. Yes, the receptionists wore the thousand-yard stares of people who had been ground down but I tell you what, no money in the world would persuade me to do their job.
I'm sorry about your folks, meister. I'm not quite there yet but I've heard how tough it can be trying to navigate the bureaucracy. None of the bit I've bolded is right but to be fair you've just described the prevailing attitude for most employees in nearly every working environment. Go to the supermarket or the pub or queue to get into a football ground or through the barriers at a train station and it's pretty common. Let's not pretend they're only in the public sector. It's a societal issue - employees who are made to feel like their contribution doesn't matter tend to behave like that.
Cheers. Absolutely they tend to get weeded out and therefore, appear to be less in numbers in the private sector. All opinion based on observation and experience of course.
We've never chucked so much money at the NHS so not sure where the financial kicking is coming from? The solutions? There may be more but some I can think of off of the top of my head, some already outlined above Proper joined up IT and communications. Management of the individual patient rather than management of cases that are passed on to different responsibility areas joined to a properly funded social & ongoing care system joined up Targets based on care quality rather than headcount. Reward for good work, a structure on improment training and untimately consequences for poor. Sorry to hear of your recent experience but was any of the lack of facilites due to there being a skeleton staff on in "non-urgent" areas due to it being the weekend? Cap-ex like expensive scanning machines need to be used 24/7 to increase the return on investment. Having endured an 8 hour visit for someone else in A&E recently myself I understand and yes the frontline staff are in the majority amazing. There's not enough of them and they don't get the backup they need. What amazed me was the number of security guards seemingly employed to sit by doors playing on their phones and press the open door button without barely looking up or challenging me a scruffy unwashed individual who'd been up most of the night, who was allowed to roam the deparment free. The ammount of times someone important looking popped their head round the curtain, looked at a clipboard and without saying anything fcked off. How we had to wait for a porter to move a bed on wheels from one side of the room to another because "the union will kick off if anyone else does it" I was actually told off for attempting it myself. How there was a huge triage queue of people who anything but urgent but likely coudln't get seen by their GP. I could go on but it was such an unlpleasant experience I'm trying to forget it and that's before I sart to talk about the resulting 4 weeks in hospital off the back of it. Frontline staff are on the whole amazing, it's the system that is letting them and us down.
Likewise sorry to hear about your bad experiences too. I’m sure we’ve debated this point before but just looking at how much is being spent is a terrible indicator. Health spending will be even higher in five years. Inflation alone will see to that. I’m spending more on groceries but I’m getting less for my money. So just to stand still the NHS is going to cost more. Health spending as a % of GDP actually went down by almost half a per cent from 2022 to 2023 at a time when everything costs more. And a lot of the increase in health spending is skewed because of the billions wasted during the pandemic, not least on PPE contracts that should result in prison sentences. Looking after the health of a nation is surely one of the fundamental indicators of a smart society and yet for my adult lifetime all anyone has done is gripe about the cost of the NHS. We should spend way way more on it until the buildings are like the head office of KPMG (or another corporate behemoth) and the staff are happy, healthy and motivated. But we won’t because there’s no obvious profit to be had, no shareholders benefit, no obvious wealth is created. other comparable countries spend more on health than we do and have better outcomes. All your suggestions so far indicate you want more staff, more hours when services are working, more equipment. The problem is the UK doesn’t want to pay for that and the idea that a few efficiency savings will sort it all out is not realistic.
Jesus, Mary, the Donkey and what not They didn't do a impact assessment of what the outcome could be - https://x.com/SaulStaniforth/status/1834130185483878576 They have no idea if it will cause extra deaths, how many additional people might end up in hospital or how many may end up as long term sick. I get that pensioners will get more than last year, but that is based around what the level of inflation was. Labour made a huge thing about inflation hitting 11% and the need for pay rises in line with inflation, just so people could stand still, not they are saying that doesn't matter. It feels like they are struggling with not being the opposition anymore and a realisation that every golden populist promise that they have made, they now have to act upon. They need to take a moment to pause and realise that the ARE the government now and understand that every decision will have an implication somewhere else along the line.
Someone needs to stop putting Streeting in front of the camera. His a walking car crash. Now people are fleeing countries and dyeing in small boat crossings, because of climate change. https://x.com/LBC/status/1834145532509368502
So do nothing then? Because that's really what a pause entails. You raise an interesting point though as I actually reckon a lot the inertia in this country comes about because of our national obsession with impact assessments, consultations, reviews, inquiries, snap inspections... and so on until time itself runs out. It's like a disease and a lot of politicians embrace it if it means they can kick tricky decisions into the long grass. And what's an 'impact assessment' really anyway? More educated guesswork from the civil service's branch of Mystic Megs, often tilted in whatever direction the government of the day wants it to find. There's so many variables it'd be about as useful as a chocolate fireguard. Plus I think it's a bit of stretch to try and label the WFA cut as remotely 'populist'. Well, he says 'war and conflict, famine or indeed climate-related migration'. I think for an answer to a baiting presenter on a national radio show that's probably a simple but fair top 3 reasons to give for why people are 'fleeing' much poorer countries. Do I think someone who's father was a farmer but now can't do that himself because of drought or excessive rain is thinking actively about climate change? Doubt it. But is that an underlying cause? It's a reasonable argument at least. Do you or anyone else know where this £10bn aid claim has come from anyway? I've searched online, including on a couple of Gov.UK department websites, and can't find anything obvious about it. I've seen the figure doing the rounds on social media in the past few days but without a source I'm dubious about it.
It won't make any difference. Until we find a politician with the balls to stand up to all the political woke nonsense that exists nothing will change. We live in a democracy where we accept the majority decision, but the reality is we don't. The media, etc, constantly focus on the small minority so the majority suffer. What I would like is a prime minster to say I serve the majority, If you don't like my decisions, and that becomes a majority view, then i'm out at the next election!
There are certain things that they need to do impact assessments on. they knew that they had an issue with the NHS, the usual winter overflow and common sense said that a cutting of the WFA would have an effect on the NHS intake. They also knew, from their 2017 assessment, that there would be an increase in additional deaths. Although an assessment isn't necessary on every single thing, matters of health, possible deaths, impact on other services and the outcome on that should always be done. Its almost negligent to not understand the impact of peoples heath and a policy that could cause additional deaths. Evan if he is sat in front of a baiting presenter, he has to be better. If he can't handle it then don't put him out there. We now live in a digital world, where every single thing that is said or written is there for ever and a day. The days of yesterdays news is todays whip paper is well gone. Eventually he will say something so ridiculous and damaging that it will stick and prove costly to him, his party and at a far extreme, security. It was an utterly stupid comment to make. I understand people fleeing war torn countries, countries of persecution, but no one is fleeing a country because of climate change, paying €10k to travel across Europe and into a small boat to get to the UK. It wasn't even an argument and not even a plausible reason. You can guarantee that this will be held against him or the government at some time. He is a liability in front of the camera in in the media, they would be a lot lot better to keep him out of the media. There has been an £11.6bn of global climet support/aid in place since 2019 - https://researchbriefings.files.parliament.uk/documents/CBP-9352/CBP-9352.pdf I think that Miliband has managed to adopt this as a policy rather than it being a new one, unless there is an extension or additional budgeting being made available.
No one is fleeing a country because of climate change, yet. As for impact assessments – I thought people wanted less red tape and more action. Again, the electorate wants everything.
I genuinely don’t understand this, although I didn’t hear the interview so perhaps I am missing something obvious. Of course people are migrating because of climate change. 32.6 million in 2022 alone, according to the European Parliament. Is it not likely some might end up in the U.K.?
The trouble is where do you draw the line? I say what follows slightly tongue in cheek but I think it highlights the folly of putting too much weight on impact assessments. If, say, 8000 more elderly people die this winter than would otherwise because of withdrawal of the WFA that probably saves HM Government quite a nice wedge in state pension payments that would otherwise have been paid over the coming years. Should they include that in the impact assessment? What about if those who die because they were cold would simply have caught flu or Covid and been hospitalised and died anyway? Or even just have died because it was their time? You'd have to offset a proportion for that. And so on... Common sense I think says the impact will be in the margins. A few thousand here and there isn't going to tip the NHS into ruin. Certainly it would be very hard, unless there's mischievous politicking going on, to pin the blame for any uptick in hospital admissions, deaths etc solely on the withdrawal of the WFA. Far bigger factors will be things like how cold it gets (something the government has zero control over), whether the NHS functions correctly (something the government has limited scope to change this winter at least) and if those affected seek help sooner rather than later (again, other than raising awareness out of government control). I think some are and in the future very many more will, even if they don't know it. 'Utterly stupid' seems like an exaggeration to me. I'd be careful of falling into the Tory press trap of only focusing on a relatively small proportion of very irregular migration (small boats). Climate change is and will drive all forms of migration in the coming decades...
I would venture a lot of the much-trumpeted ‘economic migrants’ are fleeing areas where climate change has destroyed the agricultural production & therefore wealth generation.
I wonder how many more stories we will hear like this ? Always risky I guess. https://www.bbc.co.uk/news/articles/cnvdy22gje4o
I wonder if the government coming out and saying they'll increase the winter fuel allowance by 25% so those in need are sure to be able to afford heating this winter - but that had to come at a cost of removing it from the 80% that don't need it, would go down well
Yes, but the reoffending rate for all prisoners is around 25-30%. It means that any prisoner release is risky at any time. Most can’t be kept in forever though. In this instance, it’s not made clear what the original conviction was for. If he was a previous sex offender he may not have been eligible under this scheme. In any case, it’s likely that he has simply served 40 rather than 50% of his tariff. He was coming out soon anyway.
This seems like the biggest own goal so far https://www.bbc.co.uk/news/articles/c8djply3z18o Why accept money, clothes etc? It always looks out of touch even if it’s all declared properly.
Really after being all over the Tories for this sort of thing they should be whiter than white but it's small beer in the grand scheme of things. The optics are not good agreed. Did right in fessing up imho.
Just a shambolic few days. Really, how hard is it to either not accept a load of gifts from a party donor or remember to declare them? This is grist to the mill for the 'they're all the same' crew.
Had high hopes he'd be better than this (and it's still not on the scale of Tory corruption) but it does feel the entire political class exist on freebies and perks. I work in the public sector and get to see the audit reports for gifts, hospitality and expenses. Everything needs to have a justification and if it doesn't, people get told to pay the money back or return the gifts as it's simply not appropriate. It is bonkers that politicians of any ilk think it's ok to accept clothes, glasses, holidays, free tickets from donors.
Evidence that after 14 years sitting opposite the corrupt truth-twisters there seems to have been very little recognition that while the country may not be united on many things one thing pretty much everyone wants an end to is the faces-in-the-trough culture of grasping and spivvery. Given the choice of letting a donor buy a bunch of designer clothes or not doing that it seems beyond Starmer to pick the right option.
