Poll: 2nd Leaders debate - Live tonight at 8pm on BBC news and SKY news

[Gaidin109]

blind panic[/I]" whenever he has to answer questions and Ashcroft's best friend William Hague who has been demonstrated to be thoroughly dishonest an who is as a result, being kept away from the media

Is that why William Hague has been on every political news and current affairs programme at some time or another recently?

 

[stockhausen]

... I apologise and kneel down at the feet of the clear and rational posting god and beg forgiveness ...

Ite, missa est

 

[scorza]

The usual, "I disagree with you, so you must be naive or stupid" arguement.

LOL not at all - I'm merely echoing the sentiment of the Torybois in this thread, when faced with the prospect of their beloved party not getting a parliamentary majority it's all because "the public are thickies". That said I do think it's very naive to think that the Conservatives will come in with their swingeing public spending cuts and not chop front line services.

Cutting the use of Quangos and Management Consultants within the NHS. £2bn a yer is spent on this. The cost of management bodies that oversee the PCTs has risen from £1.4bn to £2.1bn over the last four years.

Overall the cost of bureaucracy in the NHS has increased by 103% since 2003. The DofHeath, its quango and regional oversight committees had a budget of £12.6bn alone last year. Compare this to A&E budget of £1.7bn or Maternity of £1.8bn and you get the picture. This does not include the billions more spent within the PCT's themselves on administration. A report last year showed that staff numbers had risen by 18%, yet the amount spent on them rose by 48%, the rise in administrators outripped that of Doctors and Nurses.
Quango such as the Cosmetic Surgery Steering Group, Advisory board on registration of Homeopathic medicine and the Leadership and Race Equality Action Plan Independent Panel are really un-neccessary.

The NHS currently employs 5000 more managers than it does consultants

The Labour Government promised to cut spending on ALB's by 50% under John Reid in 2004, and a 25% reduction in Management and Administration in the same period. The opposite has in fact happened.

You can spin it any way you want - these QUANGOs and management consultants don't exist for the hell of it, they are there to do something. Let's take the Cosmetic Surgery Steering Group as an example - let's say we get rid of them. How do we decide what (if any) cosmetic surgery should be done on the NHS, remembering of course that the scientific evidence is there that in some cases, a negative body image can have a serious detrimental effect on the quality of life for a patient.

 

[Gaidin109]

You can spin it any way you want - these QUANGOs and management consultants don't exist for the hell of it, they are there to do something. Let's take the Cosmetic Surgery Steering Group as an example - let's say we get rid of them. How do we decide what (if any) cosmetic surgery should be done on the NHS, remembering of course that the scientific evidence is there that in some cases, a negative body image can have a serious detrimental effect on the quality of life for a patient.

Decisions such as what Cosmetic surgery can be done, could just as easily and far more cost effectively be done by the consultants that would carry out the surgery. This can be done on a case by case basis, even your GP could make a decision as to whether you need referal in the first place. You do not need another expensive service to make those kind of decisions. As the recommendations of quangos such as the Cosmetic example are not uniformly accepted by PCT's proves that they are in fact superfluous.

 

[scorza]

Decisions such as what Cosmetic surgery can be done, could just as easily and far more cost effectively be done by the consultants that would carry out the surgery. This can be done on a case by case basis, even your GP could make a decision as to whether you need referal in the first place. You do not need another expensive service to make those kind of decisions. As the recommendations of quangos such as the Cosmetic example are not uniformly accepted by PCT's proves that they are in fact superfluous.

So in effect you're arguing for a situation where treatment is basically down to "luck of the draw" for patients as to which individual consultant they get.

 

[Naffa]

I have to say scorza, you make a very good point.

 

[Dolph]

LOL not at all - I'm merely echoing the sentiment of the Torybois in this thread, when faced with the prospect of their beloved party not getting a parliamentary majority it's all because "the public are thickies". That said I do think it's very naive to think that the Conservatives will come in with their swingeing public spending cuts and not chop front line services.

On the contrary, I think that a great many people who vote for the tories are also thickies...

As for the cuts, it's very naive to think that any party will not be making significant, painful but absolutely necessary spending cuts. The frontline issue isn't, as I have said, simply the result of spending cuts, but of spending cuts and structural pressure to get the budget increased later.

Pretending that these things are only going to occur under the Tories is where the real dishonesty is coming from.

 

[Dolph]

So in effect you're arguing for a situation where treatment is basically down to "luck of the draw" for patients as to which individual consultant they get.

As opposed to the current postcode lottery of which PCT they live in?

The situation now is not one of universal availability based on what these quangos decide, Gaidin is right when he states that shows how pointless they are. There are another layer of bureaucrats that are not necessary, the question is whether you get rid of the quangos or the PCTs...

 

[Naffa]

It's just SO frustrating to hear Gordon and David arguing over who's going to maintain spending at the highest level. A lot of the questions that people asked during the debates were ridiculous as well...

 

[Gaidin109]

So in effect you're arguing for a situation where treatment is basically down to "luck of the draw" for patients as to which individual consultant they get.

How is that different to 'the luck of the draw' currently with the way in which different Trusts interpret the recommendations from such quango's. And are the Consultants not experienced and trained well enough to make these kind of decisions?. Are they any less capable of using their considerable front-line experience without the oversight of bureaucratic quango's?

 

[Dolph]

It's just SO frustrating to hear Gordon and David arguing over who's going to maintain spending at the highest level. A lot of the questions that people asked during the debates were ridiculous as well...

Indeed, but it's simply a result of the ingrained belief that a great many people in this country hold that government spending is the same as getting something 'free' and that it's the government's job to provide their entitlements.

What we need to be having is a discussion about how to bring our spending back under control (raising taxation isn't really an option because it doesn't work), what reforms will be associated with the reduction in government spending, and if we can take steps to prevent the same level of fiscal irresponsibility from occuring again, but none of that is happening.

 

[Hatter The Mad]

http://news.bbc.co.uk/1/hi/education/8640576.stm

Looks like even people within Cameron's own party are against his education plans:

To me it seems like this "big society" plan is merely a plan to privatise the education system by the back door. Let's make state run education a thing of the past by making it so bad that parents will have no choice but to ask private companies to come in and start up new schools.

“I am 100% behind Michael Gove’s education plans, which will introduce more competition, give parents more choice and help drive up standards across the country. The BBC is trying to create a division between us that doesn’t exist. An issue I have been discussing with Michael is ensuring that funding between different types of schools is fair and equitable, and I’m totally confident that this would be the case with a Conservative government.”

Statement from the counsellor.

 

[scorza]

Pretending that these things are only going to occur under the Tories is where the real dishonesty is coming from.

To be clear, I'm not saying that. The link I posted was about Labour government plans to cut the number of doctors and nurses in the NHS. My contention is that there will be more front-line cuts under the Conservatives, and I guess broadly similar to Labour's plans.

What I'm trying to do is dispel this myth that everyone seems to believe here that the NHS is full of "non-jobs" and that "efficiency savings" will be good for us as recipients of NHS care.

As opposed to the current postcode lottery of which PCT they live in?

The situation now is not one of universal availability based on what these quangos decide, Gaidin is right when he states that shows how pointless they are. There are another layer of bureaucrats that are not necessary, the question is whether you get rid of the quangos or the PCTs...

I'm against the current postcode lottery also, but at least that's a uniform managed service for a particular postcode. Having cosmetic surgery and other treatments as unmanaged services imo would be a disaster for NHS finances imo. It would be better if the NHS was run as a managed service countrywide, but for that to happen you have to have someone, somewhere answering questions like "when do we offer cosmetic surgery?" based on scientific evidence.

 

[Dolph]

To be clear, I'm not saying that. The link I posted was about Labour government plans to cut the number of doctors and nurses in the NHS. My contention is that there will be more front-line cuts under the Conservatives, and I guess broadly similar to Labour's plans.

I know, but you aren't the only person in the thread using spending cuts to attack the conservatives, and some of the others are far less honest about it than you

What I'm trying to do is dispel this myth that everyone seems to believe here that the NHS is full of "non-jobs" and that "efficiency savings" will be good for us as recipients of NHS care.

Have you seen the ONS efficiency figures for the NHS since 1997?

http://www.civitas.org.uk/nhs/graphics/productivity.JPG

Taken from http://www.civitas.org.uk/nhs/nhsperformance.php

The NHS performance has not increased in line with spending, the input and output has diverged, hence there is certainly scope for efficiency improvements. The bigger question is whether those efficiency improvements will actually happen, or whether they will cut other areas in an effort to secure a bigger budget in future.

I'm against the current postcode lottery also, but at least that's a uniform managed service for a particular postcode. Having cosmetic surgery and other treatments as unmanaged services imo would be a disaster for NHS finances imo. It would be better if the NHS was run as a managed service countrywide, but for that to happen you have to have someone, somewhere answering questions like "when do we offer cosmetic surgery?" based on scientific evidence.

But you only need that at one level, not at the three or four we have now. This is the key point. Someone needs to make that decision, and I could even accept that it may not be at hospital level (although I'm much more in favour of all out NHS reform as you're probably aware), but we don't need a group to make a recommendation, then a group to decide whether to implement that recommendation, then a group to decide how to implement that recommendation and so on...

I think the fundamental question is whether you think the centralised approach is the best one, or whether the NHS should act more like an insurer and give freedom to hospitals to do their own thing while providing the required funding for treatment. You can probably guess what my view on that is.

It simply wouldn't happen in the private sector, a decision would be made and it would be implemented that the payment would be made. Nice and simple.

 

[Naffa]

The NHS performance has not increased in line with spending, the input and output has diverged, hence there is certainly scope for efficiency improvements. The bigger question is whether those efficiency improvements will actually happen, or whether they will cut other areas in an effort to secure a bigger budget in future.

Do you think that substantial efficiency savings, and improvements, may turn to just be flat out impossible though?

 

[stockhausen]

It's just SO frustrating to hear Gordon and David arguing over who's going to maintain spending at the highest level. A lot of the questions that people asked during the debates were ridiculous as well...

Agreed; even Nick Clegg isn't as forthcoming as he should be about where the Liberal Democrats are going to make cuts.

I think that the most significant difference between the Tories and New Labour is that the Tories' cuts will inevitably be designed to have less impact on their core (i.e. richer) supporters than would be the case with New Labour who have marginally more interest in narrowing the increasing divide between the rich and the poor.

 

[Dolph]

Do you think that substantial efficiency savings, and improvements, may turn to just be flat out impossible though?

Without significant structural change, yes. The structural pressures in the NHS (and various other services) are all wrong to enable reform, and even if we could successfully bring efficiency savings, the problems would soon come back.

The problem is that it's economically beneficial to the NHS to cut frontline services and spend in the back office, because of the way the service is funded. The structural pressure is backwards compared to the normal operating structure in business, and it shows. For most businesses, improving the customer experience increases income. For the NHS, making the customer experience worse increases income.

Until we fix that problem, we will never get on top of the efficiency issues and poor frontline service. Adding ever more regulations, targets and quangos is no substitute for getting the structure right in the first place.

 

[Hatter The Mad]

Do you think that substantial efficiency savings, and improvements, may turn to just be flat out impossible though?

I don't see why. Every one of our counterpart countries in Europe manage it.

France and Germany, for example, delivers 20% more for the same inputs than what we do (survival rates, quality of care, waiting times, access to treatments, etc).

 

[Dolph]

I don't see why. Every one of our counterpart countries in Europe manage it.

France and Germany, for example, delivers 20% more for the same inputs than what we do (survival rates, quality of care, waiting times, access to treatments, etc).

Indeed, and the big thing about both those areas are that they implement a very different structure to their healthcare provision that drives efficiency and frontline service through structural pressure.

 

[RDM]

I think that the most significant difference between the Tories and New Labour is that the Tories' cuts will inevitably be designed to have less impact on their core (i.e. richer) supporters than would be the case with New Labour who have marginally more interest in narrowing the increasing divide between the rich and the poor.

Do you actually believe that? Considering all the evidence is that the divide between rich and poor has been getting greater with Labour in charge?

All three parties are talking about making the same levels of cuts more or less, if you argue cuts are bad, then you are arguing against all parties. None of the parties have given any clear ideas where the cuts are going to be made, it is a failing of all of them. no one can honestly say that the Labour cuts will be better or the Lib Dem cuts will be better or the Conservative cuts will be better. We just don't know.