Save the NHS!

[scorza]

Working as a contractor for the NHS I can see where the money gets wasted.

but this appears to address none of it. Because most of the problem with the budget and it being a cash cow is down to suppliers treating it as a cash cow and making prices up as they go along, and the NHS accepting them because its not their money they are spending.

Most likely the NHS accepts the prices because they have preferred supplier agreements with those suppliers which reduces the total cost of procurement for the NHS. Private companies have been doing this for years which means when I order a new laptop at work, it costs £1.2k for a spec that would cost me personally about £350 if I got it from somewhere like OCUK. There's a lot more to procurement than just getting the cheapest price though.

The NHS' problem is not that it needs more money.

A comparison with healthcare spending in other developed countries would suggest otherwise.

 

[Fr0dders]

The people with those preferential supplier agreements take the **** though. Because they know its the NHS, they could quite reasonably supply your laptop for .. say £500 instead of the £350 from OcUK.

But because its the NHS they deliberately push it up to £1.2k knowing the NHS will just pay it.

This sort of behavior is rife right through the NHS and its disgusting.

And don't even get me started on the wage bill.

 

[Destination]

Exactly my point from earlier, they pay on average more for everything.
A few procurment specialists paid a percentage of what they save could likely save billions overall.
Be a good first step.

mOD should be doing the same, fifty pounds for a lightbulb and all that.

 

[scorza]

The people with those preferential supplier agreements take the **** though. Because they know its the NHS, they could quite reasonably supply your laptop for .. say £500 instead of the £350 from OcUK.

But because its the NHS they deliberately push it up to £1.2k knowing the NHS will just pay it.

This sort of behavior is rife right through the NHS and its disgusting.

And don't even get me started on the wage bill.

You've misunderstood. I don't work for the NHS, I work for a private company that has a preferred laptop supplier who "overcharge" us for equipment. This is private sector best practice which it sounds like the NHS have, or are trying to, adopt. Why is it best practice? Because it brings down the total cost of procurement for the buying organisation. How? For example, a part of the procurement process should be to establish the risk of a supplier going out of business, this process can cost an organisation quite a lot of money especially if they have as many suppliers as the NHS. By reducing the number of suppliers the NHS reduces this cost. That's just one of the advantages of the preferred supplier approach.

 

[scorza]

Exactly my point from earlier, they pay on average more for everything.
A few procurment specialists paid a percentage of what they save could likely save billions overall.
Be a good first step.

mOD should be doing the same, fifty pounds for a lightbulb and all that.

It wasn't fifty pounds for a lightbulb was it though? It was £50 for an maintenance technician to arrive on site, examine the fitting, procure the right light bulb and fit it. To be fair, this sounds like something that should have been covered under a maintenance agreement, but that would have cost the NHS money too.

I know someone who got charged £60 when he moved out of his flat because one of the light bulbs needed changing.

 

[sigma]

It wasn't fifty pounds for a lightbulb was it though? It was £50 for an maintenance technician to arrive on site, examine the fitting, procure the right light bulb and fit it. To be fair, this sounds like something that should have been covered under a maintenance agreement, but that would have cost the NHS money too.

So that boils down to what we've been saying all along - poor management.

 

[Destination]

Precisely, a procurement specialist would be employed to do exactly this, on site and for future orders. I fail to believe that no one on the base knew what type of lightbulb was involved. Poor management.
Throwing money at poor management won't help improve either nhs or mod throughput.

 

[Fr0dders]

You've misunderstood. I don't work for the NHS, I work for a private company that has a preferred laptop supplier who "overcharge" us for equipment. This is private sector best practice which it sounds like the NHS have, or are trying to, adopt. Why is it best practice? Because it brings down the total cost of procurement for the buying organisation. How? For example, a part of the procurement process should be to establish the risk of a supplier going out of business, this process can cost an organisation quite a lot of money especially if they have as many suppliers as the NHS. By reducing the number of suppliers the NHS reduces this cost. That's just one of the advantages of the preferred supplier approach.

But the problem is that the amount they overcharge by isn't "just enough to bring down the total cost of procurement"

its that, and then a load more on top because its the NHS and the person with the contract at the supplier gets a nice bonus.

Its excessive.

 

[sigma]

Precisely, a procurement specialist would be employed to do exactly this, on site and for future orders. I fail to believe that no one on the base knew what type of lightbulb was involved. Poor management.
Throwing money at poor management won't help improve either nhs or mod throughput.

It's almost the same with the economy, can't keep throwing money at it in the hope that underlying problems will be magically fixed.

 

[do_ron_ron]

lol.

You get that straight from the Daily Mail?

The cheapest option will generally win yes, in every other aspect of society we are pushing competition for people to produce better products at cheaper costs. God forbid we should introduce this into healthcare as well and actually make the system cost effective and efficent

We have already seen - Panarama program - what this means - buying surgical instruments from India and Pakistan which are harmful to patient care. Or maybe the other program which showed that the food from the private contractor was hindering patient care and recovery. In the last instance, I can verify this problem. Although a different hospital to the one shown on the program, we had to bring in food for my mother as the hospital food was poor. I also noticed that other patients were getting the same service from their visitors.

 

[kokuten]

why fix something that is only half broken, it still works, just leave it be

 

[do_ron_ron]

Fair enough.

That is one example though, it doesn't mean it is indicative.

Indeed, my own experiences both for relatives and my own recent health problem was that the health service was excellent. The only fly in the ointment was the food supplied by a private company to my mother when she was in hospital.

 

[feedtheram]

Can someone explain in simple terms what the proposal is?

The NHS service for me has been very hit and miss. For serious issues the service has been world class in my experience. However for minor problems it has been what i would expect from a 3rd world country in some cases. Maternity wards in particular seem to be in a dreadful state as far as resources go.

Seems to me they need to concentrate on specific areas rather than trying to reform a massive organisation in one go - or am i missing the point?

 

[do_ron_ron]

Working as a contractor for the NHS I can see where the money gets wasted.

but this appears to address none of it. Because most of the problem with the budget and it being a cash cow is down to suppliers treating it as a cash cow and making prices up as they go along, and the NHS accepting them because its not their money they are spending.

Dolph will be sticking pins into an effigy off you for suggesting that private firms do such things.

Don't you know, private firms always provide better services for less, according to the Dolphian view of the world.

And everybody lives happily ever after

 

[scorza]

Can someone explain in simple terms what the proposal is?

Have a read of http://www.38degrees.org.uk/page/content/NHS-legal-advice/

To summarise my understanding further, there are two controversial proposals in this legislation:

1. Secretary of State for Health will no longer have a duty to provide or secure the provision of healthcare. This means when there's a major scandal in the health industry in future, the minister responsible for health will basically say "not my problem guv, it's up to your GP's surgery to sort it out". He will be required by law not to do anything that might mean a repeat of the scandal does not occur.

2. Opening up the NHS to competition. At the moment it's the Primary Care Trusts (PCTs) that commission i.e. buy health services for us. These are being dismantled and replaced by consortia of GPs surgeries who are allowed (possibly encouraged) to outsource this responsibility to private for-profit companies. In future the GPs must choose who to commission health services from "any qualified provider".

Any qualified provider means that private companies can poach the parts of the NHS it thinks it can make a profit from e.g. if I set up a production line operating theatre doing nothing but hip replacements, this will cost me much less than the NHS osteopathy department does it for. The NHS has to provide a universal healthcare service though, so the osteopathy department loses all the money from hip replacements and is left doing the difficult, expensive work that the private companies don't want to do. The NHS becomes more inefficient and costly to the taxpayer, which means it will lose even more work until we get to the point where the NHS no longer exists and Cameron, Osborne and Lansley all smoke a big cigar and pat each other on the back for a job well done.

 

[Glaucus]

How does that work, unlike RM we don't pay for health care. So companies can't pinch the cheap stuff. The NHS simply has a budget and does it at cost.

Seems like a one sided flawed opinion.

 

[Hatter The Mad]

They just need to go the whole hog, abolish the government provision of healthcare and instead have the government pay for universal healthcare insurance (and regulate the private provision of healthcare, of course).

 

[[TW]Fox]

They just need to go the whole hog, abolish the government provision of healthcare and instead have the government pay for universal healthcare insurance (and regulate the private provision of healthcare, of course).

Have you any idea how much the private healthare providers in this country rely on the NHS? Put simply, without the NHS they couldnt work. They have no emergency facilities for a start - which is why they are usually located so closely to NHS hospitals.

 

[Hatter The Mad]

Have you any idea how much the private healthare providers in this country rely on the NHS? Put simply, without the NHS they couldnt work. They have no emergency facilities for a start - which is why they are usually located so closely to NHS hospitals.

Sorry, I didn't make clear that I am not talking about emergency healthcare, just in/out patient. A&E and paramedical services is more complicated, I am not sure about that part yet.

 

[Cold_And_Miserable]

mOD should be doing the same, fifty pounds for a lightbulb and all that.

Isn't that how secret military projects are funded?