>>97397

The trouble is you're looking at it from a zoomed out perspective that averages out all the costs and benefits over the entire NHS. But the thing with PFI is that it's not uniform- There are some trusts that it works/worked pretty well for, but other it absolutely does cripple, because it puts a massive weight on their balance sheet they can't ever meaningfully control.

My own feeling is just that on a gut instinct, low-depth level, you can never square that circle of saying "you can get better value out of the private sector" when the private sector has inherent interest in profit. It might be true you can save on costs that way, but it's self evidently true that saving is going to be translated into profit, leaving you with at best, no net change. And it's never not going to work that way because any company that did otherwise and left profit on the table would have to be stupid.

>>97393
>That means every household in the UK would have to pay about an extra £87 per year in tax to fund it.
So basically fuck all, then? Especially when you weigh that against the sum of the benefits of proper staffing and the consequential costs of poor staffing.

>>97399

There are about 300,000 nurses, out of a total public sector workforce of 5.7 million. If the government give the nurses 19%, there are a lot of other public sector workers (many of them on much lower incomes) who will want similar pay settlements. Most of them wouldn't get anywhere near that amount because they don't have the same level of bargaining power or public sympathy, but a lot of them are likely to try.

If most rank-and-file public sector employees get a pay rise roughly in line with inflation, then we're looking at the thick end of £1000 per household per year - remember that this is an ongoing cost, not a one-off expense. That's a very long way from "basically fuck all". If we aren't willing to stump up that sort of money, then who doesn't deserve a pay rise? Hospital porters and HCAs? Teachers? Bin men? Soldiers?

I won't pretend to know what a nurse deserves to get paid, but I do know that the pandemic has made this country a lot poorer. Workers have every right to go on strike, but every lost day of work makes the country a bit poorer. A lot of people are justifiably angry about the squeeze on their standard of living, a lot of people are disillusioned by a government that clearly doesn't care, but the economy is in an incredibly fragile state and things could still get a lot worse.

>>97400
>then we're looking at the thick end of £1000 per household per year
That's a gross figure, and assumes the status quo is free. Chronic underfunding of public services has a direct budgetary impact, as well as societal and economic costs that have an indirect impact through reduced tax take.

>remember that this is an ongoing cost, not a one-off expense
Sure, that means we're going to have to pay taxes next year as well as this year, but thankfully most of us will also get a salary next year too.

>>97400
>If the government give the nurses 19%
Sure, but the government is refusing any and all offers of negotiation. 19% is the starting offer, not what anyone in the unions genuinely expects to get, that's how haggling works.

>>97400

>who doesn't deserve a pay rise?

Well...

>Hospital porters and HCAs?

Absolutely and unequivocally.

>Teachers?

Nah, fuck 'em.

>Bin men?

Already went on strike and got what they were after earlier in the year, if I recall correctly. Remember all thep ictures of Glasgow under piles of rubbish? Goes to show how quickly people realise how important you are when you walk out, in certain jobs.

>Soldiers?

Arguably, but then, they are replacing them with drones soon aren't they.

>Labour leader Sir Keir Starmer has said the NHS must reform in order to survive.

>He told the BBC the NHS should always be free at the point of use but there was also a role for the private sector, including to help clear waiting lists. He also proposed allowing patients to make self-referrals for conditions like back pain to cut bureaucracy.

>Asked if any reforms for the health service were off the table, Sir Keir told the BBC's Sunday with Laura Kuenssberg programme: "No, we want to look at all sorts of reform. The reason I want to reform the health service is because I want to preserve it. I think if we don't reform the health service we will be in managed decline," he added. "It will always have to be free at the point of use, it of course should be a public service. But that doesn't mean we shouldn't use effectively the private sector as well."

>The interview came after the Labour leader set out his vision for the health service in an article for the Sunday Telegraph. He argued the idea the NHS is still the envy of the world is "plainly wrong" and that the situation for patients was "intolerable and dangerous". Sir Keir also said his party would double the number of graduating doctors and district nurses, increase training placements for nurses and midwives, and gradually turn family doctors into direct employees of the health service.

https://www.bbc.co.uk/news/uk-64279654

>>97409
It's funny how the emphasis on "reform" always translates to more reheated Blair-era private sector payola and never to (say) copying NHS Scotland or other more centralised, more government-led systems .
But I've said that so often I'm half tempted to argue the opposite just to spice things up. Maybe Starmer's a genius and understands that if you hand off the NHS to the private sector they'll lobby for more money far more effectively than the current NHS and healthcare will finally get the funding it needs. (Plus a small bonus for all those aspirational, entrepreneurial shareholders, naturally.)

>>97410

>never to (say) copying NHS Scotland or other more centralised, more government-led systems

NHS Scotland is at least as fucked as NHS England; the Scottish government have substantial devolved powers to raise taxes and set budgets, they do very well out of Barnett, so there's only so much they can blame on Westminster. There aren't any other more centralised systems; the NHS is the extreme outlier in that respect.

Regardless of where you stand in terms of private sector involvement, the NHS undoubtedly does a lot of fucking daft things a lot of the time. NHS staff work very hard and put in very long hours, but they're spending a lot of that time chasing their tails because of a severe lack of management.

We've got consultants on six-figure salaries doing basic admin because ideological opposition to "NHS bureaucrats" left their departments without secretaries and clerks. The disastrous Fujitsu IT contract means that medical records are still often sent by post or by fax; doctors spend an inordinate amount of time copying something from their computer into a letter or vice-versa, because there's no standardised system for exchanging medical information. GPs are the gatekeepers to almost all NHS resources, but they aren't actually NHS employees - they're private businesses working under contract and their interests often run counter to the interests of the NHS as a whole.

The NHS needs more money, it needs more doctors and nurses, but it also desperately needs a management structure and an information architecture that's fit for purpose. If you know anyone with a chronic health problem, you'll know just how much time and effort is wasted because of a lack of coordination and information sharing.

>>97411
>We've got consultants on six-figure salaries doing basic admin because ideological opposition to "NHS bureaucrats" left their departments without secretaries and clerks...
Does "we" here mainly refer to NHS Scotland, NHS England, or both? Management structure was the primary thing I was thinking you could just copy and paste without much buggering about. Looking at it from the opposite angle: if both systems are approximately equally fucked now, but lots of time, effort and money was thrown into reforming the English NHS under Blair but not the Scottish one under devolution, one can only be left with the impression that the time and effort spent on reform would've been better spent practically anywhere else.

For clarity: I don't object to reform in the areas you describe, but (except for GPs if you're optimistic) it seems very unlikely that this is what Starmer or Streeting mean when they talk about "reform" either. If they take power I expect the list of fucking daft things the NHS does to grow much faster than it shrinks.

>>97412

>it seems very unlikely that this is what Starmer or Streeting mean when they talk about "reform" either. If they take power I expect the list of fucking daft things the NHS does to grow much faster than it shrinks.

Pretty much.

Thing is it does need reform, but nobody's going to give it the kind of reform it needs. It also needs a fuckload more money- But they want to act like reform is a magic bullet that means it doesn't need more money. It's not a binary, the NHS needs both.

There's no getting around that one though, if we want the same standard of care we've got used to, we'll have to pay for it. It'll have to come from somewhere, but we will have to. And I think people would be willing to- It's just that it would be a much easier pill to swallow (ha) if we didn't always have that subconcious assumption half of it always just disappears into the black hole of PFI contracts, extortionate procurement fees, dodgy "consultancy" firms who spunk half of it up the wall just thinking about maybe considering a proposal of what to do, and so on.

That lot is the dead weight we need to reform out of the NHS, but we've all become so accustomed to it and so wearily accepting of it, because that's just how our crooked gangster economy works, that we just take it for granted. That's why we don't want to spend more, because we know only maybe half of it actually gets to where it's needed.

>>97411
If only there were another NHS on the mainland you could look to for ideas. One that doesn't have many of those problems because they actually put in the effort into (very slowly but surely) solving them.

>>97414

Wales doesn't count, it's not so much a country as it is a kind of self-perpetuating public sector ouroboros.

>>97415
A self-perpetuating public sector ouroboros where consultants don't have to spend inordinate amounts of effort copying and pasting, GP files don't need to be shipped by motorcycle courier, standardised systems for exchanging medical information exist, nurses don't have to tell patients to store their own samples because the hospital is in a different trust to their GP, and referrals don't get lost because someone put a folder full of forms in the wrong drawer.

Perhaps the best thing we did was put fascists in charge of our NHS IT. There is one service offering, providers can take it and do as they're told or they can fuck off. WanaCry was little more than an expensive weekend of overtime mostly watching screens and doing nothing, with fewer infections than Boris Johnson has children and fewer appointments cancelled than Boris Johnson has mistresses.

>>97414

I disagree with the basic premise that the NHS in the devolved nations is any better run than NHS England. They spend more money, but their outcomes aren't meaningfully better; in the case of Scotland, life expectancy is significantly shorter than in England and the gap isn't shrinking. Scotland has been catching up with England on measures like waiting times, but that hasn't actually translated to health outcomes. Having a simpler organisational structure or spending more money is a bit pointless if it doesn't result in comparatively better performance on the outcomes that actually matter, i.e. the rates of sickness and death.

https://www.nuffieldtrust.org.uk/research/the-four-health-systems-of-the-uk-how-do-they-compare

>>97417

In fairness that gets into murky waters because you're directly conflating health outcomes with NHS performance, which isn't true. There's plenty of lifestyle and environmental factors that would affect a population's baseline health, which would obviously thus affect outcomes.

Scottish people, for instance, are the second lardiest fuckers on earth after the Yanks, with endemic gingivitis, because all they live on is deep fried Mars bar, Bucky and heroin- The Scottish NHS might be the best healthcare organisation in the world for all we know, but it's barely keeping the comically unhealthy Scottish diet and lifestyle at bay.

>>97417
>They spend more money, but their outcomes aren't meaningfully better
Wow, it's almost as if there's some difference in context between Scotland and England that might affect how much money they need to spend to achieve similar outcomes.

It's funny because every time this sort of report comes out people usually go for "do you really think they haven't accounted for that?" and pretty much every time when you look deeper it turns out that they really didn't account for that.

>>97418

>In fairness that gets into murky waters because you're directly conflating health outcomes with NHS performance, which isn't true. There's plenty of lifestyle and environmental factors that would affect a population's baseline health, which would obviously thus affect outcomes.

The Nuffield Trust analysis takes into account those baseline differences. Health outcomes across the four nations have improved over recent decades, but they've improved at the same rate. Devolved powers, greater funding and a different organisational strategy haven't made any actual difference. If anything, Scotland's performance has been worse, because they've got more low-hanging fruit available - improving the health of a very unhealthy person has a much greater impact on quality and length of life than improving the health of an already quite healthy person. There are very few interventions that can extend the lifespan of someone in the home counties with a life expectancy of eighty-odd years, but there are lots of relatively cheap and easy interventions that could extend the lifespan of a Glaswegian with a life expectancy of sixty-odd years.

The fact that Scotland haven't plucked those low-hanging fruit points to one of the fundamental issues that Labour are seeking to address; namely that we've got a National Illness Service rather than a National Health Service. Preventative interventions have a ridiculously good cost-to-benefit ratio, but they account for a tiny fraction of NHS spending. Obviously in a budget-constrained environment there's a temptation to focus on acute care at the expense of prevention, but that quickly becomes a vicious cycle. Politicians bear some of the blame, but the unwillingness to defend preventative budgets is also a failure of NHS leadership.

I'm not sure analysis of performance even should be adjusted taking those lifestyle and environmental factors into account, as though they're independent of the health body. Your GP will tell you to eat less lard or to take more exercise, and the NHS as a whole does stuff like publicity campaigns to make us run more, drink less or eat less lard. They're not just A&E and surgery, they advise on preventative measures too and the efficacy of that should probably be assessed with the rest of it.

>>97420
>Devolved powers, greater funding and a different organisational strategy haven't made any actual difference.
Equally: greater private sector involvement, the various management reforms and restructurings, NHS Foundation trusts and all the rest of it obviously haven't made any actual difference. But Labour's clearly still keen on giving them another go - and it's very obvious they're far more keen to tackle resistance to another ride on the reform merry-go-round amongst healthcare staff than they are to tackle lifestyle factors, which might be rather difficult for a health secretary who gleefully welcomes McDonalds to his party conference.

But I'd dispute the point on funding too: Relative to other services, my recollection is that the NHS has arguably been quietly squeezed in Scotland. That is to say, it's been getting more money in real terms, but less compared to other services than it was pre-devolution. This was true under both Labour and SNP administrations. Also, the Nuffield Trust offers the North of England as a closer analogue for devolved countries and shows that it got both increased funding and improved outcomes. Spending money on cures rather than on prevention may not be the best way to go about things if it can be avoided, but it's nonsensical to imagine the money does nothing just because reduced A&E waiting times are of no aid to the people who get eaten by the Loch Ness monster.

They were on about the ambulance strike on Jeremy Vine's radio show. They had lots of paramedics and 999 call centre workers ringing in to say that people are abusing the system by requesting ambulances if they've got a tummy ache or small graze. They've undoubtedly got a point, but the message of the show was clearly blaming the public for abusing the system and taking the NHS for granted rather than holding the government accountable in any way.

>>97452

This is really a case where I'd be fine with seeing enough resources go to the NHS that peripheral "abuse" of the system like this would be annoying but negligible. I think this only frustrates workers because things are so bloody tight at the moment.

>STRIKES RANT THREAD

I'm on strike tomorrow which you think would mean I can look forward to a nice midweek rest. Unfortunately the Mrs has now unexpectedly asked if we might go to the swimming pool tomorrow and I'm taking a look in BHF at second-hand furniture they have in stock which should only be the start of things.

And I'm only going to come back to more work the next day. Arse biscuits.

>>97470
Good luck with it mate

>>97470
A good premise for a sitcom episode would be a main character getting a reputation as a scab after going into work during a strike, but only because he didn't want to go furniture shopping with his girlfriend. Unfortunately this sitcom doesn't exist so by writing this I've wasted my own time and yours. I'm sorry.

>>97472

I was on the Rudgwick earlier and people were talking about parents and their kids being scabs for still sending them in. I don't think they quite understand the concept.

>>97470
>I'm on strike tomorrow which you think would mean I can look forward to a nice midweek rest

Get out on that picket line and earn your £50 you lazy fuck.

>>97452

NHS resources would be better spent if people actually turned up for their appointments too. We could make huge progress in reducing waiting list numbers if only people would let us know that they can't turn up for clinic or surgery, and free up the slots for someone who can. Hospitals get fined for breaching the 18-week referral to treatment pathway, seriously impacting their individualt budgets, so this really is something that the public can do something about. Or maybe just petition the Government to change it to a 3-year pathway so it looks like the DHSC is performing better.

>>97474
>earn your £50 you lazy fuck

Strikers earn £50/day? How does that work?

>>97475

Most unions have a strike pay fund to compensate their members for lost pay due to strikes. Obviously those funds aren't infinite, but they're a useful tool in motivating people who might otherwise be tempted to cross a picket line.

So who else are on strike today? I've just found out that the Land Registry are so I'm guessing a lot of civil servants will be.

Saw the video of that husband calling in to Nick Ferrari's radio show to carry on an argument about going on strike that he lost with his wife, who's a teacher. Absolutely pathetic. There's no way she isn't going to have an affair.

>>97478
And the producer of Nick Ferrari's show now has their phone number! Although I know a guy who does a bunch of these shows, and apparently he is very successful so it could be him doing it, and if Dave is the producer then Dave is gay and it'll be fine.

>>97474
>>97476
You fucking what, I understand there's an emergency strike fund but it's something where I'm paying over a fiver more into for people in genuine hardship. I didn't realise I was paying normal people's bennies.

Fucking socialism for ya'

>>97479
The thought that it was "too good to be true" did occur to me while I was listening to it. But I think that about basically everything I see online these days so it's hard to tell when I'm being paranoid.

I didn't have my pay deducted last month for the strike. Obviously I didn't think to make any noise about it and just assumed that they would eventually take it out of some future pay. Or forget. Now I'm hearing that some people had two days pay deducted and their employer has told them they will be paid the missing monies on their next paycheque.

Glad I'm not working in HR at the moment, the whole thing sounds like a complete shitshow.

There was a ballot notice went around at my work the other day, so pathology services might be joining in on the strike.

Not that it will matter, because no fucker knows we exist anyway. We're only involved in 90% of diagnoses, with doctors entirely leaning on us to cover their own arses (and to blame us when they fuck up), and were the people carrying the entire fucking health service through covid, but if you ask any average person what a biomedical scientist does, they'll have no bloody clue will they.

I mean, it would totally half the process of appointments and surgeries and everything if we all put tools down and stopped doing people's pre-appointment bloods and MRSA screenings and what have you; but just imagine fucking Munchetty trying to explain what that means to the nation on Breakfast.

>>97558

>half

* Halt.

>>97558
What is your one asking for? I'm wondering if the cancelled train strike is a sign of things settling.

>>97559
Maybe those perfidious doctors have a point?

Munchetty is like a sip of hot caramel on a cold morning. I will not have you disparage her.

>>97560

They didn't really tell us, presumably because they haven't made their mind up about exact demands yet, but I assume just to make sure we're not left out if they reach a settlement with the nurses and ambulance drivers etc. Or to keep the pressure up if they get to negotiations.

We've already had localised strikes for the last few years already about various trusts consolidating their labs, moving staff to sites that are a pain in the arse to commute to, offer worse turnaround times because they're harder to transport specimens to, and making redundancies; but none of them succeeded. So while I hate to be defeatist, I already know we don't have all that much leverage in the grand scheme of it.

It also doesn't help that (at my place, at least) half of us are in Unite and half of us are in Unison, and it was only Unison sending the ballot. So at best they'll only have half a strike. But it did say "to all pathology departments", so presumably it's a general walkout rather than just a local tiff.

We will see I suppose.

>>97561
>half of us are in Unite and half of us are in Unison
That there's a split between two groups of those names is beyond parody. And by beyond I mean not very good. A throwaway joke at best.

>>97562
After the chronic wage stagnation, the worst thing about the crushing of the unions in the 80s and 90s has to be that we lost nearly all the good names. No more fun with acronyms like NUPE, NALGO, or APEX sitting around in tripartite negotiations on wage differentials, no more names that make sure to leave no doubt who's in the union like the Prudential Staff Union, the National Union of Dock Labourers, or the Oldham and District Weavers', Winders', Reelers', Beam and Sectional Warpers' Association. Sooner or later they'll probably even take away your throwaway joke by merging Unite and Unison into a new union with a name like Consignia, and then what will we do?

>>97562

Well, you see, it's the result of what happened when they previously merged labs, and all the staff from one lab were Unite, and all the staff from the other were Unison.

If they carry on with it we'll just have one super-lab that serves the whole of England, and it'll have about 40 staff, but with efficient management and a couple of WASP machines they'll comfortably be able to process 30,000 samples a day. To ensure reliability it'll be located centrally, somewhere with good access to rail and motorway links, such as Aberystwyth.

It'd be quite funny if it didn't mean I might be out of a job one day. But oh well.

>>97564

>To ensure reliability it'll be located centrally, somewhere with good access to rail and motorway links, such as Aberystwyth.

After three years of logistical disasters, they'll decide to build thousands of miles of pneumatic tubes. The project is finally delivered, just ten years late and £80bn over budget, at which point they realise that they don't have any means of access if a pod gets stuck. After a failed effort to dislodge a pod stuck in the Cornwall-Aberystwyth leg with a 300 mile long drain rod, someone will have the bright idea of turning up the pressure to force it loose. Somewhere around the 300 bar mark, the whole of England bursts, flinging large chunks of countryside into low earth orbit. Rishi Sunak will declare it a tremendous success for the British space industry.

>>97565

Implying any of these clowns will be in office by then. Labour will be forced to accept the blame for the eruption of pressurised diarrhoea that devastates a small south Wales mining village. They will solve the issue by bringing in private contractors to manage each region's stretch of tube.

What exactly am I supposed to do when I join a picket line? Do I just stand around awkwardly, occasionally shouting some pre-approved lines and waving a sign menacingly?

I thought I might go march on Number 10 tomorrow because a news report featuring with a load of people would distract from whatever goodies come out of the Spring statement but it's a lot of effort to get there with TfL's strike.

>>97567
Take a guitar and sing a song like Lisa Simpson.

>>97567

>What exactly am I supposed to do when I join a picket line? Do I just stand around awkwardly, occasionally shouting some pre-approved lines and waving a sign menacingly?

Basically, yeah. In theory you're there to discourage people from crossing the picket line and going in to work, but in practice you're mostly there to be seen by the general public. Your union will almost certainly send a rep down to hand out banners and make sure that no-one does anything illegal.

>Ministers have made a breakthrough in their talks with civil servants over pay after backing down to offer officials in less senior roles a one-off payment of £1,500 to help with the cost of living.
https://www.theguardian.com/politics/2023/jun/02/uk-ministers-back-down-and-offer-civil-servants-1500-to-end-pay-row

How does a one-off 'cost of living payment' of £1,500 stop the effects of inflation outpacing wages?

>>97732
Every day a deal is delayed is a day when those workers are without the pay rise that should have already been agreed and implemented by now. If this helps cement a deal sooner rather than later, then they're going to start receiving the agreed pay sooner rather than later. This deal should have been agreed in time to be paid in April. We are now into June, and there's a possibility that it's already too late to get a deal signed off in time to hit June payroll. Obviously it doesn't do anything about "sticky" inflation (i.e. prices for some goods subject to crisis inflation not returning to pre-crisis levels), but at the same time back pay received in September doesn't help people today.

Junior doctors and consultants are going out on the 20th of September and the 2nd to 4th of October. Try not to die.

https://www.bbc.co.uk/news/health-66674058