BS: The Compensations Of Capitalism

Subject: BS: The Compensations Of Capitalism
From: Stu
Date: 19 Jan 11 - 12:39 PM

It's been a fine day for neo-capitalist wonks the world over.

In the UK the NHS is just about to be shagged into submission by the mighty tory member that Thatcher was itching to take to it but didn't have the hairy balls to. Luckily, the balls have dropped of the shiny and well-scrubbed Etonion advocate of the 'big society' and in boringly (boorishly?) predictable fashion is intent on handing a wodge of it over to the private sector.

Goldman-Sachs have flicked two fingers (or given the bird for our US brothers and sisters) to everyone suffering the hardships of the recession by gleefully paying over $15 billion in bonuses to it's staff. Heck, and we're worried about the NHS and libraries closing! Foreclosures? Pah! Usury? The way of the future!

Meanwhile, in the White House the capitalist elite finally shrug off the chains of morality (the emperor's new chains?) by feting the dictator of a brutal, vicious and horrifically oppressive regime and agree the Tibetans, freedom of speech and just about anything else pertaining to human rights (except of course being a consumer) and personal freedom can go fuckkity-bye. After all, we've got to make a few quid haven't we. They'll be singing with joy in the Laogai tonight (the guards that is).

Looking forward to the rest of 2011!

Subject: RE: BS: The Compensations Of Capitalism
From: GUEST,Steamin' Willie
Date: 20 Jan 11 - 04:14 AM

I seem to have lost my bet...

I genuinely thought that in the period between the Health White Paper and yesterday's bill, that the more silly and (in my opinion) totally wrong parts of NHS reforms would be quietly dropped.

Problem is, I know a bit about the subject, having chaired a couple of NHS trusts, helped develop PCTs and advised Ministers on the business of trying to run healthcare. I am not saying for one minute that I am the fount of all knowledge, and I have been proved wrong about as many times as anybody else, but........

The GP consortia that are already working in shadow form have all, without exception, blown their budgets. The doctors' trade union (British Medical Association) have woken up to the idea that Ministers want GPs to be the ones seen by the public to be rationing healthcare. The 2008 act (Labour in on the act) allows both NHS and private healthcare to be seen to be the same, and The Care Quality Commission is set up to regulate them as individual entities, and take it from me, working in the field, NHS bodies can only work in cooperation with other NHS bodies, dependent on the governance of others, something the regulations don't take into account. Ergo, NHS models are set up to fail in the quality regulations, where a huge NHS trust with seven large hospitals etc etc is judged by the same yardstick as a domicillary care agency.

You know what the real problem is? Not this government at all, but every single government that has come to power since Thatcher has seen The NHS as a toy to play with, to inflict ideologies on, using structural change as their legacy. I for one am getting a bit fed up of it.

I read today a quote from one commentator who said, rather succinctly, that in order to sink The NHS boat, managers don't need to sabotage it, they just need to take their eye off the ball for a second. (Possibly the second when they read their redundancy notices.)

In the meantime, NHS trusts, when they are seen to be failing, will be sold off to multi national companies for a song. No doubt the government will waive the historical debts too, as they always seem to roll over to the city. (The debts by the way equal the amounts spent on "reforms" over the years, according to an interesting report by the Audit Commission.)

Subject: RE: BS: The Compensations Of Capitalism
From: Stu
Date: 20 Jan 11 - 04:29 AM

Thanks for the post Willie, and as my wife worked in the NHS (patient-facing as it were) I know many NHS workers of whom I have a high opinion, and I'm pretty sure they would agree with much of what you say.

Thing is, the NHS actually works well at the moment. It's various agencies seem to communicate, and in my experience having had a spell of treatment as an out-patient it's been efficient, my case was expedited without loosing any quality of care and the whole experience gave the impression of a system that worked.

There will be problems, there always are, but I'm not sure why carving it up for the jackals when it works perfectly well is a good idea. When will people get the idea in their heads that the NHS is NOT about making money. Madness this way lies.

Subject: RE: BS: The Compensations Of Capitalism
From: Bonzo3legs
Date: 20 Jan 11 - 05:09 AM

Thank goodness I use BMI Healthcare.

Subject: RE: BS: The Compensations Of Capitalism
From: GUEST,Steamin' Willie
Date: 20 Jan 11 - 05:32 AM

Good for you Bonzo.

However, just bear in mind that as much as I see the place for private provision in a universal healthcare system, it is complimentary rather than replacement.

As our friends over the pond know, the cost of serious healthcare is not a cost such companies enjoy having, and the costs are too much to pass on. So the difficult cases? they pass them up and good old NHS has to save the day yet again.

A few years ago, I was asked to go to the USA and spend some time with Kaiser Permanante to look at their primary care models. All good stuff and we learned a lot, (KP also learned from us, especially in terms of clinical governance.) However, part of the treatment regime for them is to decide between the cost of intervention versus the cost of making somebody comfortable.

If I am proud of one thing about The NHS, it is that in 98% of cases, the clinical rather than the cost option is the one you receive. Yes, some drugs are not financially viable, but the organisation looking at such things (NICE) will say that 3months extended poor quality life is not worth, say £200K of tax payers money, but spending over three million to save a life can be, (one example being a bilateral leg amputation for a haemophiliac, costly to say the least...)

Yes Jack, the NHS is not about making money, although to be fair, it isn't about wasting it either. My concern is that there is a difference between coming in on budget and coming in on budget plus profit. That is the main difference between private and state provision. If the private sector is more efficient, then the state run organisations need to improve, not accept that you need to be private to be efficient. I have never, either as CEO of a large private concern or as a "leader" in The NHS, said that only the private sector can run a business.

Of course, history would prove me wrong, but that doesn't mean that future has to....

Subject: RE: BS: The Compensations Of Capitalism
From: Stu
Date: 20 Jan 11 - 05:57 AM

Good points again Willie.

At least Cameron knows his place. When summonsed, he goes skittering in to his bosses: From The Grauniad.

Subject: RE: BS: The Compensations Of Capitalism
From: Backwoodsman
Date: 20 Jan 11 - 06:09 AM

"Thank goodness I use BMI Healthcare"

Well don't thank it too much Bonzo - you may find yourself, as I did, with a life-threatening illness requiring two lots of major open-surgery, which:-

a) my private health insurance didn't cover the hospital level that was essential for the procedures to be carried out, and
b) even if it had, the consultant (one of the top men in the field in the UK) wouldn't do it privately, only on the NHS (God bless that fine man!).

So, I ended up having three years-worth of treatment, including two operations and numerous stays in hospital, in one of our best teaching hospitals, and at the taxpayers' expense. And a damn fine job those men and women did - I'm eternally in their debt.

Subject: RE: BS: The Compensations Of Capitalism
From: DMcG
Date: 20 Jan 11 - 07:48 AM

I see from this link that "GPs face losing control of managing the flu vaccine programme following supply problems in England this winter, the government's head of immunisation says. There is a "pretty compelling" case for the government taking charge of ordering and supplying jabs, said Professor David Salisbury."

Of course, the fact the government may have to take charge because the GPs can't get the procurement and management right has no bearing on their plans to put all the procurement and management in their direction ...

Subject: RE: BS: The Compensations Of Capitalism
From: Richard Bridge
Date: 20 Jan 11 - 06:53 PM

Good heavens. Save to add Thatcher to the villains I agree with Mr Fluids. Willie, you perhaps also overlook that the objective of Mr Condom and his fag is to reduce the rest of us to servitude.

Oh, and allowing private health to use NHS facilities is worse than sleeping with the enemy.

Subject: RE: BS: The Compensations Of Capitalism
From: GUEST,Steamin' Willie
Date: 21 Jan 11 - 09:47 AM

Ah well, Richard.

My old trust had a health centre with a minor intervention unit, (a room that was classed as an operating theatre for small interventions such as vasectomy, podiatry etc.)

The costs of keeping it up to scratch was quite a bit, but the cost of sending patients to the local acute hospital was much more, not to mention the longer wait for patients.

You know what we did? We slept with your enemy. It made good sense, a good deal for patients and tax payer too. We rented it out at weekends to a company doing cataract operations privately, and the income from that more than paid for the upkeep of the theatre, as well as giving the health centre a lick of much needed paint.

Allowing private health to use NHS facilities can be a bad thing, or it can be a good thing. As ever, individual circumstances have to be taken into account. And the income can make a big difference. the private hospitals on NHS hospital sites bolster NHS services by the income allowing money to be spent on patient care, not to mention helping waiting times.

I am not a fan of the business thrust of many private healthcare companies, and having spent time regulating them, I can say with full conviction that the NHS generally competes favourably in terms of safety, quality and outcome. But they do have a place, and it is not just the worried well either.

But as I said above, I see their role as complimentary rather than replacement. (Although foundation status does make NHS trusts private in many ways, albeit we are the shareholders.)

Subject: RE: BS: The Compensations Of Capitalism
From: Richard Bridge
Date: 21 Jan 11 - 01:52 PM

Oh, I'd never heard of an underused NHS facility - most seem to be about 125% utilised, so any private use is a denial to the NHS. And I think you mean complementary.

Subject: RE: BS: The Compensations Of Capitalism
From: Stringsinger
Date: 21 Jan 11 - 02:34 PM

Safety, quality and outcome of the private insurers is not within the reach of unemployed and underemployed or working poor in the U.S.

We need our own NHS big time with Single Payer government run insurance.
Oh yes, democratic socialism would be welcome also.

Subject: RE: BS: The Compensations Of Capitalism
From: mousethief
Date: 21 Jan 11 - 02:42 PM

Your lips to God's ears, Stringslinger.

Subject: RE: BS: The Compensations Of Capitalism
From: MikeL2
Date: 21 Jan 11 - 03:27 PM

Hi

I am with Willy on this one - he appears to me to know what he is talking about.

I have several reasons to to be thankful for our NHS. I have had two seperate episodes of cancer. First I had a prostate problem followed some years after by throat cancer.

At the time I was in BUPA through my employers. Do you know what?? As soon as cancer was diasgnosed I was sent IMMEDIATELY to consultants on the NHS.

My treatments and aftercare were first class and thankfully I am here to tell the story.

Recently I needed a small minor operation and found that my GP and my medical centre have acquired a small operating theatre on their premises in which our own doctors perform minor operations without us needing to go through a hospital.

At week-ends this facilty is rented out to a private company that performs cosmetic surgery. As I understand it , this pays for the upkeep of the operating theatre and premises and in no way interferes with the performance of the NHS medical centre and it's GPs.

Through this, waiting times have been reduced and if my experience is anything to go by the whole thing is far better than having to go into hospital.

While I applaud this I am still very cynical about the "plans ??" of the Condems with their new ( unannounced in their manifesto ) of the changes that they envisage for the NHS. I am also concerned about the speed at which they are trying to get the project off the ground. There has been no test projects or models of their proposals to give any indication of what potentional problems that will occur.

To me it is like going to sea in a new untested ship with any life belts.

cheers

MikeL2

Subject: RE: BS: The Compensations Of Capitalism
From: Backwoodsman
Date: 22 Jan 11 - 02:59 AM

And I'm with MikeL2 and SW.

Subject: RE: BS: The Compensations Of Capitalism
From: Stringsinger
Date: 22 Jan 11 - 06:04 PM

Mousie, I don't think god is interested. He's too busy looking after his investments on Wall Street. Oh, sorry, that's the CEO for __________(fill in the blank)