30/11 Strikes.

[Pottsey]

My wife started her working life as basic office admin in the public sector and the pay was much better than she could expect in the private sector. As I said, it will vary from position to position, profession to profession so a blanket "The pay is worse" statement is just not going to work.

I do not believe that’s been true since Job Evolution hit where office staff took a massive pay hit, frozen pay for 4 years and all the pension changes. As for pensions I have no problem paying more into pensions. It’s the retiring at a later date I disagree with.

 

[Hatter The Mad]

Ok I get this, but do you think a privatised health service would provide better or worse service to their 'customers'.

Monopolies always deliver worse value and results to the consumer. We know this. This is why we let our governments spend years and billions of our money on monitoring the markets, preventing monopolies, breaking them up or spending money to create and encourage competition in an otherwise locked market.

However, we are perversely more than happy it seems to allow a monopoly on some things that are very important to us - health and education.

Money is not (or is not just) the solution to better education and healthcare. We need consumer choice. That's another word, I'm afraid (and I'm afraid because it seems to cause some people to crap their pants) for market forces.

DO you think the private providers would be more interested in balancing bank sheets or actually saving lives.

If their income is absolutely tied to saving lives and delivering the best (and 'the best' would be relative to their competition), they will be more interested in saving lives and providing the best care to their patients.

It is human nature, it is also capitalist nature. At the moment we have a situation where everyone in an under-performing NHS hospital keeps their job, everyone still gets paid (or even paid more), even if results are poor (ie people die). Customers will keep coming in because we, the customers, don't have a choice. Government imposed 'targets' are soft. At the end of the day, the hospital won't be shut down. Where's the motive to improve and for the Leeds PCT to provide better healthcare than the Bradford PCT?

The biggest and most powerful thing we as consumers have is our choice. Our choice to take our custom (and thus money) to another provider. We currently do not have that choice. We can have it with our without introducing a profit motive into the NHS or education, but that is another debate.

All that matters right now is that we are currently devoid of consumer choice, largely because the public buys into this myth that 'competition is bad' and it has been perpetuated by people who think along the lines of John Prescott ('the problem is that if we build a good school in an area, people will want to go to it').

profit driven solution really the answer when we are talking about real peoples lives being at stake.

You currently trust the private profit motive to build your washing machine. You have a good washing machine which runs efficiently, is relatively good for the environment, didn't cost the earth and is reasonably well built. You also trust the profit motive and competition for companies like Siemens to build life support machines, or to produce food you may feed to your baby. If the profit motive is inherently bad and results in worse output, you wouldn't trust any of this.

 

[Hatter The Mad]

I made some edits to my post to add a bit more, for anyone who might currently be replying!

 

[Delvis]

How's this for a novel idea?

How about those that have rubbish pensions get off their back sides and fight for something better?

Or it it just easier to write into the Daily Mail and state how envious you are of all those that have already done just that?

Come again? I already have a pension, is it as good as the teachers have already? (ie final salary pension) no.

But it's good enough for me currently

 

[wildman]

If their income is absolutely tied to saving lives and delivering the best (and 'the best' would be relative to their competition), they will be more interested in saving lives and providing the best care to their patients. The biggest and most powerful thing we as consumers have is our choice. Our choice to take our custom (and thus money) to another provider. We currently do not have that choice. We can have it with our without introducing a profit motive into the NHS or education, but that is another debate. Either way, we are currently devoid of consumer choice.

How will 'delivering best' be quantified. Previous governments tried this with those insane league tables, min / max waiting times etc, and that simply turned the NHS into a top heavy Bureaucracy where total number of administrators and managers needed to enforce these crazy mandates outstripped actual hands on workers.

NHS needs reform to bring it into the 21st century, but I am yet to see a convincing rationale for full privatisation that will not end up costing lives.

You currently trust the private profit motive to build your washing machine. You have a good washing machine which runs efficiently (good for the environment), didn't cost the earth and is reasonably well built. You also trust the profit motive and competition for companies like Siemens to build life support machines, or to produce food for babies. If the profit motive is inherently bad and results in worse output, you wouldn't trust any of this.

that's not even in the same ballpark, comparing the manufacture of goods to the saving of lives / human life is simply a poor argument.

 

[RDM]

I do not believe that’s been true since Job Evolution hit where office staff took a massive pay hit, frozen pay for 4 years and all the pension changes.

It was quite a while ago, in the era when all public sector workers were alledgely paid a pittance and did it for the good of the nation.

As for pensions I have no problem paying more into pensions. It’s the retiring at a later date I disagree with.

The problem is that the amount you would have to be would need to be increased considerably if you were to keep exactly the same benefits. Any employer contributions are effectively coming off general taxation or departmental budgets. Find an online pension calculator (http://www.hl.co.uk/pensions/interactive-calculators/pension-calculator) and see just how much you would need to save for the pension you are getting!

 

[Hatter The Mad]

How will 'delivering best' be quantified.

Waiting times, treatment times, success rates, how many people die, improvement rates, whether or not patients prefer the customer service and waiting room decorations.

Previous governments tried this with those insane league tables, min / max waiting times etc, and that simply turned the NHS into a top heavy Bureaucracy where total number of administrators and managers needed to enforce these crazy mandates outstripped actual hands on workers.

Yes, because the targets were soft. At the end of the day, targets failed or not, the money will still be there, the choiceless patients still coming in, and people still have their jobs. It turned into a top-heavy bureaucracy because the targets were top-down (bureaucracy enforced) rather than bottom-up (consumer choice).

that's not even in the same ballpark, comparing the manufacture of goods to the saving of lives / human life is simply a poor argument.

I disagree. If you trust market forces to produce food you'd give to your baby, or the car you carry your family in at 70mph+, why would you not trust market forces to deliver services?

 

[wildman]

I disagree. If you trust market forces to produce food you'd give to your baby, why do you not trust market forces to deliver services?

do you think a private company running the health service would be prepared to spend thousands on keeping someone alive when they could get a better P&L at the end of the year if this person was dead and buried ?

That's a serious question, we already see instances where some people get treatment and some don't depending on what trust they are within. Hence why I will always agree that reform is needed, but reform that ends up in more importance being given to bottom lines than actually patient care are not the way forward.

 

[elmarko]

So final salary schemes are just a variation of a Ponzi scheme and the government are trying to get out of paying and the victims are striking?

Pretty much all pension schemes are nothing more than glossy'd up pyramid schemes (which never end well).

The problems of the UK (also pretty much every single other western nation) are not going to be solved by a few cuts.

The issues are systemic & built into the system.

The old system was unsustainable & needed some pretty serious changes - what worries me is how little things have changed in the economic world, after each near miss we keep on heading towards the same big ice-berg.

Personally, I'd let it all crash - it's going to happen sooner or later, we may as well let it happen & deal with it now - while we still have a fully functional infrastructure.

 

[Vonhelmet]

Pretty much all pension schemes are nothing more than glossy'd up pyramid schemes (which never end well).

Huh? Pretty much no defined contribution pension schemes are pyramid schemes.

 

[Hatter The Mad]

do you think a private company running the health service would be prepared to spend thousands on keeping someone alive when they could get a better P&L at the end of the year if this person was dead and buried ?

Yes, because if the company allowed people to die, they wouldn't get the custom (nor the license from the government to operate).

I think you forget or don't realise that we already have whole hospitals which are privately run for the NHS and do not do what you are fearing.

 

[wildman]

Yes, because if the company allowed people to die, they wouldn't get the custom (nor the license from the government to operate).

I think you forget or don't realise that we already have whole hospitals which are privately run for the NHS and do not do what you are fearing.

several hospitals v a whole system is not the same. if the entire system was profit driven by private firms I am still failing to see how they wouldn't put shareholder value for money ahead of saving Dorris the 98 year old pensioner or treating billy the 2 year old with some rare disease. These things are simply not cost effective and would have a negative impact on the overall P&L.

 

[Hatter The Mad]

several hospitals v a whole system is not the same. if the entire system was profit driven by private firms I am still failing to see how they wouldn't put shareholder value for money ahead of saving Dorris the 98 year old pensioner or treating billy the 2 year old with some rare disease. These things are simply not cost effective and would have a negative impact on the overall P&L.

Firstly, they would be licensed and regulated (thus would need to uphold certain standards in order to have a license to offer services). Secondly, patients (customers) would not go to a hospital which as you put it 'put shareholder value for money ahead of saving Dorris the 98 year old pensioner'. They'd go to the one next door, which didn't.

That's the very point of consumer choice. You go to the good hospital with the good reputation.

 

[wildman]

Firstly, they would be licensed and regulated (thus would need to uphold certain standards in order to have a license to offer services). Secondly, patients (customers) would not go to a hospital which as you put it 'put shareholder value for money ahead of saving Dorris the 98 year old pensioner'. They'd go to the one next door which didn't.

and what happens if the one next door is actually out of their reach geographically because of their location ? You see its not that simple. The NHS was / is and should continue to be a good idea. It should provide uniform standards of treatment across the board. What shouldn't happen is that people start piling into the next hospital down the road because the 'service' is better. That leads to over subscription which will lead to decline in services.

We should not be seeking to introduce this sort of competition into the NHS, we should be focusing on having equal standards across the entire spread of Hospitals / GPs etc and not force people to have to seek out the best places.

Privatisation by its very nature would not give us this, it would give us a highly competitive environment where patient care would suffer at the hands of margins.

 

[Adsta]

I was basically taking a swipe at your contradictory rant. You have a better job offer, that will be easier and pay better. You currently feel your job is hard work and taking a big toll on your life, and pays less.

You really are in 'your own world' if this is true and you let it persist .

Why thank you for your swipe at me... I already have another job which I shall be joining in March 2012 in Brussels. Because frankly I am sick of this country and as was abundently clear in my post sick of my job.

Only 4 months to go roll on march

 

[Hatter The Mad]

and what happens if the one next door is actually out of their reach geographically because of their location ?

If there is a market gap to fill (ie if there is only one underperforming hospital in an area), another would open to compete to fill the gap. Or in other words, the same reason why independent coffee shops still open next door to two Starbucks branches. It's pretty simple.

 

[[TW]Fox]

I have a moral objection to working for an employer that takes money rather than earns it, so I wouldn't work for the public sector.

So if a council receives money which it spends on wages for bin men and operating costs for some bin lorrys, it has taken money.

But if Dolph Trash Ltd receives money from the council which it spends on wages for bin men and operating costs for bin lorrys it has earned money?

Excellent.

 

[wildman]

If there is a market gap to fill (ie if there is only one underperforming hospital in an area), another would open to compete to fill the gap. Or in other words, the same reason why independent coffee shops still open next door to two Starbucks branches. It's pretty simple.

and while we wait for this new private hospital to open people carry on dying ? Its not simple, stop trying to compare retail industry to healthcare, drinking a homogeneous poor tasting coffee from starbucks won't kill you, not getting treatment for some medical conditions will there is a massive difference stop trying to pretend there isn't

 

[Hatter The Mad]

and while we wait for this new private hospital to open people carry on dying ? Its not simple, stop trying to compare retail industry to healthcare

Well what do we have now?

Underperforming hospitals cause more people to due compared to a neighbouring hospital, and we're waiting years for investigations (run by investigators who are interested in protracting the investigation, because they're getting paid to do it) and new management to be brought in to enact some more policies and more managerial responsibilities, for which they can pay themselves more for. Some hospitals never get turned around, but they remain open and remain the only choice for patients.

No difference.

It is simple. Stop trying to make it seem complicated simply because the clear-as-day logic of introducing patient choice into the NHS flys against your emotional reaction to the prospect.

 

[Glaucus]

and while we wait for this new private hospital to open people carry on dying ? Its not simple, stop trying to compare retail industry to healthcare, drinking a homogeneous poor tasting coffee from starbucks won't kill you, not getting treatment for some medical conditions will there is a massive difference stop trying to pretend there isn't

And why not stop trying to say its not possible.

Private health care is very good, it also works in other countries.

Not that I Think it should be totally private.

But you saying they'll let people die is just BS, license, criminal prosecution, profits and the rest.