Mossack Fonseca

[Animal is a Ram]

Public service should not be about profit - if it does, should be ploughed straight back in to improve.

Privatising introduces shareholders, and shareholders expect financial return. 

The only return someone should expect from the NHS, is good quality care which is free at point of use.

[1of4]

2 hours ago, jono said:

Surely a national health service is a means to deliver health care to the general population free.

if a government pays a private contractor to do that then you can't really say they are draining the national health service. They are trying to reduce the cost. As it happens I agree on the point that some of these private companies cut corners and need to be brought to book by proper oversight and contractual management.

what You Really mean is that the government is trying to cut its payroll while maintaining a level of service and you don't think it's working. .. Ok, I'd join you in fighting to get private companies to do a proper job but the principal of trying to be efficient isn't wrong. Under Blair and Brown we saw a huge shift in public employment. In times past there was a trade off .. Secure public sector job with decent pension but somewhat less in the pay stakes. Versus the private sector with higher wages but a less secure, a riskier environment and patchy pension provision.  What we have seen over the last 20 years is public sector pay outstrip private pay which in turn massively increases the burden on the public purse through actual wages and future pension guarantees. A large public sector with high wages and gold plated pensions is expensive. Like for like / contribution for contribution a pensioned state worker gets a benefit that is somewhere between 2 and 3 times the contributions they have made will actually support. 

You can't keep spending that you don't have no matter how noble the cause otherwise you end up like Greece and we all end up with nothing. 

Private companies need to make a profit, so in stead of 100% of the money allocated by the government to health care going to the NHS, only 80% will be spent on services with 20% going as profit.

[Gaspode]

20 minutes ago, 1of4 said:

Private companies need to make a profit, so in stead of 100% of the money allocated by the government to health care going to the NHS, only 80% will be spent on services with 20% going as profit.

But if a private company is 30% more efficient than the NHS, you may well get a better service for the same overall cost - it's not as black & white as some would like to make out....

[Posh Ram]

Yeah, introducing "profit" isn't always a bad thing, especially in developed countries in the U.K. where, in terms of health, private companies would compete over quality rather than quantity. 

[GboroRam]

12 minutes ago, Gaspode said:

But if a private company is 30% more efficient than the NHS, you may well get a better service for the same overall cost - it's not as black & white as some would like to make out....

They get 30% more efficient by screwing the workforce for an extra 30%.

I don't understand how the public sector is perceived to be unable to do something that the private sector can. Like as humans we're only motivated by making money. Take profit away an suddenly it's not worth bothering with.

[Wolfie]

10 minutes ago, GboroRam said:

They get 30% more efficient by screwing the workforce for an extra 30%.

I don't understand how the public sector is perceived to be unable to do something that the private sector can. Like as humans we're only motivated by making money. Take profit away an suddenly it's not worth bothering with.

Or.....they are more efficient by reducing costs by paying the actual market value for goods in a competitive environment, rather than the £22 per light bulb that the NHS has been paying.

IMO it needs to be a mix of public and private sector (for easily substituted goods & services). The public sector can provide the same services but it's normally at a higher cost - which means that we all pay more taxes.

[Gaspode]

Unfortunately (due to health issues for various members of my family), I've come into contact with the NHS far too many times over the last couple of years. Whilst in the main, the actual 'care staff' have been great (though nowhere near the quality of the 'external' Macmillan nurses), the administrative side is utterly incompetent in the majority of cases. Now it may well be that the combination of suppliers is one of the reasons that NHS admin don't know the difference between their backsides and their elbows, but the levels of inefficiency and duplication have to be seen to be believed.

I was being conservative (with a small 'c') when I suggested that a private company could be 30% more efficient - I suspect any half-decent privately run organisation could save far more than that percentage.....We should all be proud of a health service that provides free care at the point of need - and fight to keep it that way - but how that care is delivered does not necessarily need to be via someone with 'NHS' at the top of their payslip.....

[Ramarena]

24 minutes ago, Wolfie said:

Or.....they are more efficient by reducing costs by paying the actual market value for goods in a competitive environment, rather than the £22 per light bulb that the NHS has been paying to private organisations, through the Private Finance Initiative scheme..

IMO it needs to be a mix of public and private sector (for easily substituted goods & services). The public sector can provide the same services but it's normally at a higher cost - which means that we all pay more taxes.

FTFY.

I don't disagree with the start of your second paragraph. But on your last sentence, I would disagree, especially in the healthcare sector. The NHS has one of the lower spends, per capita in comparison to other leading economies. Yet it is the only fully "public" healthcare system.

The U.S healthcare system has the highest spend per capita, and is notoriously wasteful, whilst being fully private. 

 

 

[1of4]

If private companies are better at running things more efficiently, privatise the government get rid of the PM and the cabinet bring in a CEO with a board of directors and we can save money by not having an election every five years and the wages of redundant staff ( MPs)

[jono]

2 hours ago, StivePesley said:

Hmm  - I see where you are coming from, and you quite rightly point out that private companies cut corners (or as they would have it "maximising profits")

In terms of providing health care that is simply unacceptable. The NHS should not be about someone making a profit.

I also take your point Stive. What a patient needs has to be a clinical judgement but there isn't a bottomless pit. Where do you stop ? Medicine is so much more advanced than when the NHS was started. I don't know what an MRI scanner costs but someone has to make it and they will only do that to make a profit. Then someone has to buy it. ( the nation) They save countless lives. So do we have an MRI scanner and trained operator / doctor in every GP's surgery. ? Should all desirable treatments be available on the NHS ? And how do you define desirable ? The this term "profit"... Profit is not wrong and shouldn't be an ugly word. Surely we all only go to work to profit from our labours ? ... I have a relative who used to supply the NHS with equipment and some of the purchasing decisions they make are diabolically ineffective, wasteful and expensive. I genuinely believe that some admin ranks in the NHS are on a bigger gravy train than most politicians .. Sadly this is to the detriment of the front line staff and the service as a whole. 

Ironically although I think you and I differ politically I have no doubt we share a measure of scorn for some subcontracting companies .. Who I believe must make a profit but in return must also provide service to the agreed standard and pay fair wages with fair contracts. And many don't ... Wooah we might be nearly agreeing on something 

[Stive Pesley]

42 minutes ago, jono said:

I genuinely believe that some admin ranks in the NHS are on a bigger gravy train than most politicians .. Sadly this is to the detriment of the front line staff and the service as a whole. 

 

We can DEFINITELY agree there!

What really needs to happen is a root and branch review of how to run the health service efficiently, but that in itself has to be done in an efficient, and more importantly, unbiased manner. Half the problems we face are because of corporate lobbying which leads to the politicians making decisions that favour those who stand to profit, rather than those who need to use the service.

I think we are agreeing that it's all wrong, but I'm being more idealistic and living in dreamland thinking we can fix it, whereas you're being more realistic and telling us we're fooked whatever happens

 

[LesterRam]

I currently wait approximately 4-5 weeks for a non emergency Doctor's appointment, now in Malta if you feel poorly you can trot down to your local pharmacy and if it beyond them you are passed onto the resident Doctor, It works very well and I don't understand why this cannot be rolled out over here.

regarding the NHS it's looking more likely this will be privatised.

[Shang]

If the junior doctors fail, a private insurance subscription based system will be put into effect. First we will be allocated "health budgets" to make sure one single person doesn't over use resources and we will have to "top up". Then the private companies complain they're not making enough profit (via TTIP protections) which will mean moving to an American style system with even worse health care for the population. No way of fighting back if we stayed within the EU as a national parliament we couldn't revoke European-wide legislation.

A lot of this has been publicly spoken about by Jeremy Hunt (before taking office as secretary) and the head of NHS England, Simon Stevens (before taking position as NHS England). Jeremy Hunt and David Cameron's advisor on health, co-authored a book about the exact way this will happen. This isn't exactly a hidden agenda and all of this is smoke and mirrors to distract from the destruction of a national treasure. Putting blame on the workers is a common ploy to force through privatisation, it's harder for the government to force things through because making doctors sound greedy and self-serving is almost impossible.

[jono]

59 minutes ago, StivePesley said:

 

I think we are agreeing that it's all wrong, but I'm being more idealistic and living in dreamland thinking we can fix it, whereas you're being more realistic and telling us we're fooked whatever happens

 

There's nothing wrong with dreams. We need idealists just as we need pragmatists. My own feeling is that it is more than politics. It's about ethics. There really is no difference between "a fair profit" and a "fair days pay" 

somehow as a society we need to re think basic behaviour patterns. I don't know how old you are Stive but the prejudice and bigotry that was seen as normal and reasonable by all classes 40 years ago would be laughed at and derided in today's world, and rightly so. No easily voices in public the sort of racism or antipathy to minorities that was pub or office banter 2 generations ago. If we are to advance as a society I don't think it is about socialism, demanding our rights or satisfying our wants. It's about standards of acceptable behaviour. Defining the lines that shouldn't be crossed. 

How does that come about ? I am not sure but did you read about that consultancy group that got a govt grant to re write HMRC tax demands ? .. I don't remember the figures or details but this guy had a theory about shaming people rather than threatening them. They changed the wording on tax demands putting in things like 91% of people pay their tax on time. The tax paid funds the health service and peoples old age pension. .. The successful collection rate doubled .. They covered the cost of the experiment in weeks. 

I get arsey and argumentative with certain elements on the left because there is often the implication that they are the only custodian of ethics. In fact in business there are many decent ethical entrepreneurs and both sides of the political spectrum have their share Cowboys ..... although they operate in subtly different ways. 

Right that's me done .. Let's stuff Charlton 

[GboroRam]

3 hours ago, Wolfie said:

Or.....they are more efficient by reducing costs by paying the actual market value for goods in a competitive environment, rather than the £22 per light bulb that the NHS has been paying.

IMO it needs to be a mix of public and private sector (for easily substituted goods & services). The public sector can provide the same services but it's normally at a higher cost - which means that we all pay more taxes.

But why does it need someone to make a profit to realise a £22 light bulb is overpriced? 

[jono]

7 minutes ago, GboroRam said:

But why does it need someone to make a profit to realise a £22 light bulb is overpriced? 

Because when you have monolithic organisations people in power get complacent because someone else is paying the bill.

it shouldn't happen but it does and has done over eons. when there is money slopping around people drink it whatever their politics. The choice seems to be greedy corner cutting outsource supplier versus lousy buyer at state enterprise .. Now whether that lousy buyer is corrupt or inept is open to debate but they are one or the other ! 

[GboroRam]

3 hours ago, jono said:

Because when you have monolithic organisations people in power get complacent because someone else is paying the bill.

it shouldn't happen but it does and has done over eons. when there is money slopping around people drink it whatever their politics. The choice seems to be greedy corner cutting outsource supplier versus lousy buyer at state enterprise .. Now whether that lousy buyer is corrupt or inept is open to debate but they are one or the other ! 

We've proven that public sector organisations can perform equal if not better than the private sector. Usually in the run up to privatisations - prove it can be profitable and flog it off. I choose to believe it doesn't need someone fleecing the country to make an organisation work. That's just propaganda that they want you to believe. 

[uttoxram75]

The only way the country can afford a National Health Service is if it is totally free of for profit ideology.

It has to be ran as a complete service and not as small profit centres. The buying power of a centralised NHS would make everything so cheap that the country would easily be able to sustain a full health service.

 

[eddie]

1 hour ago, uttoxram75 said:

The only way the country can afford a National Health Service is if it is totally free of for profit ideology.

It has to be ran as a complete service and not as small profit centres. The buying power of a centralised NHS would make everything so cheap that the country would easily be able to sustain a full health service.

 

Can I have your liver?

 

[Gypsy Ram]

8 minutes ago, eddie said:

Can I have your liver?

 

Get in line geeza