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The future of the NHS (if any)

...on serious topics that don't fit anywhere else at present.
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Alan H
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Re: The future of the NHS (if any)

#41 Post by Alan H » April 6th, 2012, 4:29 pm

Latest post of the previous page:

Anyone any idea what evidence Lansley based his 'reforms' on?
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

Nick
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Joined: July 4th, 2007, 10:10 am

Re: The future of the NHS (if any)

#42 Post by Nick » April 6th, 2012, 4:32 pm

Alan H wrote:It is utterly irrelevant where it was published.
You think so...? I'd have thought it highly significant. Oh well.
What does matter is that it was written by someone in the thick of it - Richard Horton, Editor of The Lancet.
Hmmm... an argument from authority...? And Andrew Lansley isn't in the thick of it? Do you think the government should be overthrown, as Horton suggests?
Nor do I care what some other person might have said, whether or not it was published in the same issue.
Ah, but as a GP, surely he is also in the thick of it! Aren't you in favour of occupying maternity wards as suggested? (I bet the medical staff would be pleased...!) Are you just cherry-picking?
Nor do I care to speculate on what what I might have thought if he had said something completely different to what he actually said.
OK, well, assume I've said it. What is the difference? Any thoughts? :D

Nick
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Re: The future of the NHS (if any)

#43 Post by Nick » April 6th, 2012, 4:45 pm

All sorts of sources of evidence, I'd imagine. He's had the health brief for 9 years, which is pretty amazing. I don't think he just worked it out on the back of a fag-packet...

phalarope
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Re: The future of the NHS (if any)

#44 Post by phalarope » April 6th, 2012, 4:50 pm

Maybe he was influenced by the Adam Smith Institutehttp://www.adamsmith.org/research/reports/refo ... th-service

Nick
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Re: The future of the NHS (if any)

#45 Post by Nick » April 6th, 2012, 5:30 pm

phalarope wrote:Maybe he was influenced by the Adam Smith Institute

http://www.adamsmith.org/research/repor ... th-service
I've corrected your linky, phalarope. :)

Lansley is not suggesting total private provision, nor an insurance based system, nor any co-payment.... Apart from that.... :D

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Alan H
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Re: The future of the NHS (if any)

#46 Post by Alan H » April 6th, 2012, 5:48 pm

Nick wrote:
Alan H wrote:It is utterly irrelevant where it was published.
You think so...? I'd have thought it highly significant. Oh well.
It's a 'poisoning the well' logical fallacy - you want to dismiss what's said because of what other people may have said on the same website about other things.
What does matter is that it was written by someone in the thick of it - Richard Horton, Editor of The Lancet.
Hmmm... an argument from authority...?
No, it's not an argument from authority. Horton is in a position to have knowledge and experience of the situation and that means that his views do count for something - they should be inspected carefully, of course, rather than dogmatically followed, but they should not be dismissed summarily.
And Andrew Lansley isn't in the thick of it?
No. He's not in the thick of those who have to implement his 'reforms' and can judge the impact on patients.
Do you think the government should be overthrown, as Horton suggests?
The article says that Horton called for the Bill to be overturned - not the Government - and the use of the democratic process at the next election, yet you talk of overthrowing the Government? Why?
Nor do I care what some other person might have said, whether or not it was published in the same issue.
Ah, but as a GP, surely he is also in the thick of it! Aren't you in favour of occupying maternity wards as suggested? (I bet the medical staff would be pleased...!) Are you just cherry-picking?
No. You're trying to engage in a bit of what Andy Lewis calls 'Whitabootery'.
Nor do I care to speculate on what what I might have thought if he had said something completely different to what he actually said.
OK, well, assume I've said it. What is the difference? Any thoughts? :D
No.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

phalarope
Posts: 63
Joined: February 19th, 2012, 3:35 pm

Re: The future of the NHS (if any)

#47 Post by phalarope » April 6th, 2012, 6:21 pm

Correct Nick, but the article has a lot going for it all the same. Sell the NHS off I say, but that will never happen.

Nick
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Re: The future of the NHS (if any)

#48 Post by Nick » April 7th, 2012, 1:00 am

Alan H wrote:
Nick wrote:
Alan H wrote:It is utterly irrelevant where it was published.
You think so...? I'd have thought it highly significant. Oh well.
It's a 'poisoning the well' logical fallacy - you want to dismiss what's said because of what other people may have said on the same website about other things.
There's plenty else wrong with the piece, so I'm not relying solely on its location, but Red Pepper aint really the centre of rational enquiry, is it...?
What does matter is that it was written by someone in the thick of it - Richard Horton, Editor of The Lancet.
Hmmm... an argument from authority...?
No, it's not an argument from authority. Horton is in a position to have knowledge and experience of the situation and that means that his views do count for something - they should be inspected carefully, of course, rather than dogmatically followed, but they should not be dismissed summarily.
OTOH, he might just be a political hack. It is startling just how far he has departed from any pretence at a peer-reviewed opinion. He would never let such a piece of trash be published in the Lancet if it were medical research. (at least, I hope not!)
And Andrew Lansley isn't in the thick of it?
No. He's not in the thick of those who have to implement his 'reforms' and can judge the impact on patients.
So someone who has been studying the overview for 9 years knows nothing? Just because he disagrees with you? And an editor knows everthing? That doesn't do you credit, Alan.
Do you think the government should be overthrown, as Horton suggests?
The article says that Horton called for the Bill to be overturned - not the Government - and the use of the democratic process at the next election, yet you talk of overthrowing the Government? Why?
Hmmm... that's an alternative, I suppose, but note that he calls the government undemocratic. So every coalition is undemocratic, huh? And how much democracy is there in the Lancet?
Nor do I care what some other person might have said, whether or not it was published in the same issue.
Ah, but as a GP, surely he is also in the thick of it! Aren't you in favour of occupying maternity wards as suggested? (I bet the medical staff would be pleased...!) Are you just cherry-picking?
No. You're trying to engage in a bit of what Andy Lewis calls 'Whitabootery'.
Dunno anything about Andy White, but if it is appropriate for you to quote "someone in the thick of it", then why not me too? I take it you would not like to find the hospital "occupied" next time you needed an emergency op.?
Nor do I care to speculate on what what I might have thought if he had said something completely different to what he actually said.
OK, well, assume I've said it. What is the difference? Any thoughts? :D
No.
Pity... Because it is just as valid a question.


BTW, there's a great response in the comments section, which bears quoting (and saves me time :D ) :
Salisbury says:
March 23, 2012 at 7:31 am
You would have thought that the editor of a peer-reviewed medical journal would wish to preserve some sort of reputation for objectivity and eschew the applause-seeking rhetoric of the bar-room politician. The veracity of phrases like “a new era of private sector colonisation of health services” and “a phase of unprecedented chaos in our health services” is dubious at best, but Richard Horton excels himself when he states that “people will die thanks to the government’s decision to focus on competition rather than quality in healthcare”. Not might die, or could die, but will die – said with a certainty that would be instantly disallowed if a drug company, for example, made such claims about the effects of one of its products, even with a bank of randomised control trial data behind it.

Where is Mr Horton’s evidence that the Government’s health reforms will kill patients – isolated that is from all the other factors, avoidable and unavoidable, that lead to people dying all the time while they are in the hands of the NHS? What studies can he cite, either from this country or from abroad, that might support this wild assertion? What credibility does he have calling for evidence about the impact of the reforms, when he is clearly someone who has already made up his mind?
It is also a little hilarious that somebody who states as his objective not just to oppose the reforms but to “remove” the Government, can claim to be working “outside politics”. Mr Horton is entitled to advance reasoned opposition to the Government’s policies, but this sort of gross and unsubstantiated language demeans both him and the office he holds
Spot on, if you ask me. :D And saves me writing it. :D

ETA: I've just noticed this is my 7,000th post! Nurse! The screens....!

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Alan H
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Re: The future of the NHS (if any)

#49 Post by Alan H » April 7th, 2012, 9:53 am

phalarope wrote:Correct Nick, but the article has a lot going for it all the same. Sell the NHS off I say, but that will never happen.
What would your ideal be? The US system?
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Dave B
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Re: The future of the NHS (if any)

#50 Post by Dave B » April 7th, 2012, 10:08 am

With the exception of kids, pregnant women and those on certain benefits, who remain on the NHS, they sold off the dental service. I have been trying to find some stats on dental health since the privatisation, unsuccessfully so far, but I doubt that serious dental problems needing NHS action (because the sufferer cannot afford the private dentist) have reduced.

At least we have that buffer. In America dental problems have reached such a point that there are charity "fairs" of volunteer dentists travelling around to extract rather than repair teeth for the less well off members of society, mainly to prevent the tooth and gum disease causing more serious, even life threatening, problems later.

I don't think we want to get into that state in this country with general health care, phalarope. Can you afford to pay for a consultation for every problem that you currently take to the doctor? If you can't and that little sore spot that you think is a persistent pimple turns out to be cancer . . .
"Look forward; yesterday was a lesson, if you did not learn from it you wasted it."
Me, 2015

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Alan H
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Re: The future of the NHS (if any)

#51 Post by Alan H » April 7th, 2012, 11:05 am

Nick wrote:
Alan H wrote:
Nick wrote:You think so...? I'd have thought it highly significant. Oh well.
It's a 'poisoning the well' logical fallacy - you want to dismiss what's said because of what other people may have said on the same website about other things.
There's plenty else wrong with the piece, so I'm not relying solely on its location, but Red Pepper aint really the centre of rational enquiry, is it...?
Not relying 'solely on its location'??? Relying on its location one iota is wrong. So far, you've not pointed out anything wrong with the article other than condemn it for where it is published, but I couldn't give a fuck if it was written in Marxist Times, the Telegraph or the BNP Daily: what matters - and what only matters - is what THAT article says, not what someone else says about something else. Let me put it this way: Do you think Horton has any power of veto over other articles written for Red Pepper? Does its editor ask Horton for his advice on what editorial line he should take on various issues? If Horton has no say, influence or control over what other people say in their articles, how can what they say somehow give a different meaning to his words?
Hmmm... an argument from authority...?
No, it's not an argument from authority. Horton is in a position to have knowledge and experience of the situation and that means that his views do count for something - they should be inspected carefully, of course, rather than dogmatically followed, but they should not be dismissed summarily.
OTOH, he might just be a political hack.
Well, he might be. Or he might be an alien. Whatever.
It is startling just how far he has departed from any pretence at a peer-reviewed opinion. He would never let such a piece of trash be published in the Lancet if it were medical research. (at least, I hope not!)
'Peer reviewed opinion'??? But it's NOT a piece of research and it's NOT published in the Lancet - it's an opinion piece, based on his knowledge and experience of working in medicine. Another straw man.
And Andrew Lansley isn't in the thick of it?
No. He's not in the thick of those who have to implement his 'reforms' and can judge the impact on patients.
So someone who has been studying the overview for 9 years knows nothing? Just because he disagrees with you? And an editor knows everthing? That doesn't do you credit, Alan.
No. You've misunderstood. Lansley has no medical qualifications; he has a BA in politics; he has never worked in the NHS or any medical profession; he has no experience of the system or of working with patients. Get the idea? Horton is a medical doctor and has medical experience, even though he is now an Editor. He is far closer to the sharp end than some transient politician. Lansley may be 'in the thick of it' politically - and that includes, of course, his connections with private healthcare companies - but I'm not sure his two ward tours can be described as clinical experience. However, I'm sure you don't need any reminding that it's not just Horton who is speaking out against these 'reforms', is it?
Do you think the government should be overthrown, as Horton suggests?
The article says that Horton called for the Bill to be overturned - not the Government - and the use of the democratic process at the next election, yet you talk of overthrowing the Government? Why?
Hmmm... that's an alternative, I suppose
An alternative??? No. It's the difference between what he actually said and what he didn't say.
but note that he calls the government undemocratic. So every coalition is undemocratic, huh?
Are you reading a different article?
And how much democracy is there in the Lancet?
I can't believe this. What the Lancet is or isn't is irrelevant. It doesn't - as far as I'm aware - represent itself as a democratic organisation. It's a medical journal.
Ah, but as a GP, surely he is also in the thick of it! Aren't you in favour of occupying maternity wards as suggested? (I bet the medical staff would be pleased...!) Are you just cherry-picking?
No. You're trying to engage in a bit of what Andy Lewis calls 'Whitabootery'.
Dunno anything about Andy White [sic], but if it is appropriate for you to quote "someone in the thick of it", then why not me too? I take it you would not like to find the hospital "occupied" next time you needed an emergency op.?
Why do you persist on asking my views on this? We could have a discussion about this, but it's not what the article is about, is it?
OK, well, assume I've said it. What is the difference? Any thoughts? :D
No.
Pity... Because it is just as valid a question.
So is the influencing of Ministers and other Tory MPs by private healthcare companies who stand to gain from these 'reforms'. So is the profits of those companies. Perhaps we could also talk about them later?

The article is about the 'reforms', their impact on patients and how doctors are mobilising to form a new political party to take part in the democratic process to try to ensure that these 'reforms' are reversed. There is a discussion to be had about this - whether they will garner enough support, how the 'reforms' could be reversed, etc, etc, but we've been unable to even start on those issues yet, because we've been diverted on spurious and irrelevant ones.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
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Re: The future of the NHS (if any)

#52 Post by Alan H » April 21st, 2012, 10:28 pm

We're all in this together, remember. Except some are more in it than others. (Apologies to George Orwell.)

Andrew Lansley backs lower pay for NHS staff in poorer areas
Andrew Lansley, the health secretary, is threatening another controversial revolution in the NHS by proposing that its staff be paid less if they work in poorer parts of the country.

The cabinet minister is backing a plan for regional pay, which would mean that nurses, midwives, hospital porters, cleaners and paramedics would earn less if they work in the north or the Midlands rather than in the south of England. Official documents reveal that the only exemption backed by the Department of Health would be for highly paid managers working in new bodies established to deliver Lansley's controversial NHS reform programme, widely criticised as a privatisation of the health service.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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getreal
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Re: The future of the NHS (if any)

#53 Post by getreal » April 21st, 2012, 11:12 pm

The whole "market force" thing was disbanded in Scotland and it seems to me that our NHS is a bit more robust as a result. We are centrally controlled (from Edinburgh) and theer is agreement (Scotalnd wide) as to who provides what specialist treatments. We have done away with trusts and health is back to the old Boards. The ambulance serice is a health board and covers the whole country, as a result we don't have problems providing an ambulance service accross boeard boundries. We have one centre in the entire country which provides cochlear implants. this means that patients from throughout Scotland are treated in the same hospital and the staff have been able to build up a great deal of expertise as they do this all the time (I'm just giving this as an example).

It seesm to me that moving away from market forces and towards more central control has benefited us.
"It's hard to put a leash on a dog once you've put a crown on his head"-Tyrion Lannister.

Nick
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Re: The future of the NHS (if any)

#54 Post by Nick » April 22nd, 2012, 8:43 am

getreal wrote:The whole "market force" thing was disbanded in Scotland and it seems to me that our NHS is a bit more robust as a result. We are centrally controlled (from Edinburgh) and theer is agreement (Scotalnd wide) as to who provides what specialist treatments. We have done away with trusts and health is back to the old Boards. The ambulance serice is a health board and covers the whole country, as a result we don't have problems providing an ambulance service accross boeard boundries. We have one centre in the entire country which provides cochlear implants. this means that patients from throughout Scotland are treated in the same hospital and the staff have been able to build up a great deal of expertise as they do this all the time (I'm just giving this as an example).

It seesm to me that moving away from market forces and towards more central control has benefited us.
I have no knowledge of the Scottish system, so I can't comment directly. Nor do we have enough information to make a final analysis. (This does not, of itself, mean you are wrong, of course. :) ) But I would make a couple of observations. Just because something is in some way "easier" for the people working in the industry, doesn't necessarily make it "better". Secondly, one of the suggested advantages of introducing a market into health care is an increase in specialisation, such as the cochlear ops. you cited. The reaction? Everyone screamed bue murder. Not only could they no longer have the op done locally, but it was said that medics in training would no longer have the wide experience of medicine if different procedures were hived off to specialist units. And yet, I bet, if services were now localised in Scotland, there would be screams of destroying the excellence of the NHS. What people hate is change. But sometimes change improves things. We shall see, soon enough.

Nick
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Re: The future of the NHS (if any)

#55 Post by Nick » April 22nd, 2012, 8:56 am

Alan H wrote:We're all in this together, remember. Except some are more in it than others. (Apologies to George Orwell.)

Andrew Lansley backs lower pay for NHS staff in poorer areas
Andrew Lansley, the health secretary, is threatening another controversial revolution in the NHS by proposing that its staff be paid less if they work in poorer parts of the country.

The cabinet minister is backing a plan for regional pay, which would mean that nurses, midwives, hospital porters, cleaners and paramedics would earn less if they work in the north or the Midlands rather than in the south of England. Official documents reveal that the only exemption backed by the Department of Health would be for highly paid managers working in new bodies established to deliver Lansley's controversial NHS reform programme, widely criticised as a privatisation of the health service.
Oh dear, oh,dear, oh dear. So! If we accept that there is a finite amount of money available for the NHS (and the Tories proposed more money for the NHS than Labour did at the last election) then what the unions are proposing is that medical treatment should be restricted so that some staff can be overpaid. Terrific! Furthermore, it already happens, and has been happening for years. We have London weighting, don't we? All that is being proposed is that wages should be a relection of supply and demand for labour.

I have to admit that I think some care has to be given not to exploit the vocational aims of certain people (nurses come to mind), but I see no reason whatsoever why anyone should be paid more than is required, just to reflect market forces in another part of the country.

Taking a less emotive example, if this is appled to local government, say, it means that local businesses, which have to survive in poorer areas of the country, cannot recruit the staff they need, at a level the local economy can stand (they have to sell their products and services, don't they?) because the best have been suck up by the public sector.

Sorry, Alan, but this is the Guardian spinning for the unions, and nothing more.

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Alan H
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Re: The future of the NHS (if any)

#56 Post by Alan H » April 22nd, 2012, 10:47 am

Nick wrote:I see no reason whatsoever why anyone should be paid more than is required, just to reflect market forces in another part of the country.
But it's OK not to include all those new highly paid managers, isn't it? They're a special case, aren't they. We need them to run this brave new market-driven, privatised health service. Without them, the new NHS wouldn't be able to function. Serco, Virgin Health and Bluebird would be unable to take over from those already doing an excellent job. Their shareholders might suffer for god's sake. And if we don't pay them top dollar, they will go elsewhere - perhaps even abroad. They need to be exempt from market forces. Market forces are just for the minions.

Nurses, doctors, cleaners, ancillary staff? Let them have pay cuts. Or does anyone really believe that these market forces will result in giving pay rises to those in the south?

As I said, we're all in the shit together. Ideology wins every time.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Dave B
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Re: The future of the NHS (if any)

#57 Post by Dave B » April 22nd, 2012, 11:07 am

Hear, hear, Alan.

Nick, you should go into politics, you are beginning to sound more and more like a Tory politician as the months go on!

Or is that a compliment? :D
"Look forward; yesterday was a lesson, if you did not learn from it you wasted it."
Me, 2015

lewist
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Re: The future of the NHS (if any)

#58 Post by lewist » April 22nd, 2012, 11:08 am

The labourer is worthy of his hire, irrespective of market forces. The members of this unelected cabal are not very bright and they fail to see the divisions they are exacerbating.

'Market forces' is the language of Thatcher, the unelected dictator who wrecked the morals of the nation. State funeral? A few years in Cornton Vale for reset is what she should have got.
Carpe diem. Savour every moment.

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Alan H
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Re: The future of the NHS (if any)

#59 Post by Alan H » April 22nd, 2012, 11:36 am

lewist wrote:The members of this unelected cabal are not very bright and they fail to see the divisions they are exacerbating.
Cabal? Certainly. Unelected? Unfortunately, they were elected and we are currently stuck with them. But I'm sure they know EXACTLY what they are doing - divide and conquer. Keep the proles in their place and force them to worry about paying the bills so they don't have time to organise opposition to their Lords and Masters. However, they seem hell bent on their own annihilation at the next election. And the LibDems will be not be far behind them - or perhaps leading way out in front? Not that many of them care. I'm sure they'll find well-paid jobs at Serco et al waiting for them, at salaries unsullied by dirty market forces.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
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Re: The future of the NHS (if any)

#60 Post by Alan H » April 22nd, 2012, 12:42 pm

Dr Eoin Clarke's take on this:
Lansley's plan to pay NHS staff less: what it really means

I have now read the 114 page document by Andrew Lansley's Department that proposes to pay NHS staff in poorer areas less (you can read it here). Below I outline the small print so that NHS staff can understand as quickly as possible what it means for them.

1. The plan is for this to begin on 5 April 2013. There is scope for hold ups/delays and so there is a chance we could secure a further year's delay on this.

2. The areas that will be worse affected are the East & West Midlands, the NE, the NW and Yorks & Humber. The SW also looks set to be adversely affected.

3. The DoH claim it is up to a third cheaper to live in these mentioned areas than the home counties & London, so the worse case scenario is that staff would be a third worse off. I suspect that will be mitigated somewhat and the true inequality/real terms cut in pay may be closer to 20%. 

4. The DoH plan to use a zonal pay system similar to the Ministry for Justice. This would work by identifying, inner London,  outer London, the SE and potentially the East of England as areas that deserve special treatment. There is some scope within DoH proposals to allow some hot spots in the poorer areas to be exempted but if this were the case it would be the posh areas of the poor north.

5. The plan is to set centralised pay boundaries for the poorer regions. Some scope would be allowed for localised collective bargaining within that but the potential success of such bargaining would be limited by these nationally centralised boundaries. This severely damages Trade Union bargaining power.

6. The very sad news is that women & nurses will be the worst affected. There seems to be less of a drive on punishing doctors, and the report gives a sense that the maintenance staff are already subject to forms of pay differential. I also get a sense from the report that health administrators have already suffered some pay differentials, but I have to be honest and say the document is very deliberately vague on that.

7. In terms of implementation, we are still await impact assessments that would consider how best to apply this. Logic would dictate that it could best be achieved by a) freezing current pay, b) topping up the SE, London wages & c) applying the new pay scales to new recruits. Sadly, I cannot rule out the DoH imposing pay cuts on during the next round of wage negotiations which begin in 48 weeks.

8. The other sad news is that this report actually admits the NHS will lose out on recruiting the best staff to the NHS as they are now more likely to go to private companies. The report also admits that this will damage social mobility in the North. What it does not admit, is the extent to which this will impinge upon local economies as buying power of consumers decrease. This will, in effect, enshrine regional ineqality.

9. The other aspect of the report missing, is the merger of CCGs that has already accelerated a postcode lottery. In short, wealthy CCGs are clubbing together especially in Birmingham, Bristol and Bath and leaving the CCGs that cater for poor areas to fend for themselves. Pulse have shown that this has accelerated a post code lottery on a monumental scale.  This has also affected the East of England considerably, but no special allowance or recognition seems to be made for extra hard work GPs and nurses serving poor patients will have to carry out. Indeed, one may argue that these medical staff deserve more pay, not less, for the impossible task that now awaits them.

10. The one piece of good news for northern NHS staff is that it may be possible to commute this decrease in pay not through the wage packet itself but through the perks sometimes offered to NHS staff. The DoH raises the possibility of reducing the value of assisted childcare to make it reflect the local market more. They also spoke vaguely of bringing other perks into line. It is not clear if they mean bonuses, mileage or other perks.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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Alan H
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Joined: July 3rd, 2007, 10:26 pm

Re: The future of the NHS (if any)

#61 Post by Alan H » April 22nd, 2012, 2:59 pm

Let's look at an ambulance cleaner. A responsible job, possibly cleaning up bodily fluids, re-stocking - all to CQC standards:
To work as part of a team at specific London Ambulance Service station, in the cleaning and preparation of the vehicles, ensuring that the standards of cleanliness are consistent with the National Standards. After assessment, to drive the vehicles to the nearest fuel station and refuel them, on a daily basis, you will need a Class 1 driving license to carry out this task. To clean the vehicles inside and out, on a daily basis as per specifications. To replace consumables in the vehicles on a daily basis as per specifications. Basic Health and Safety Certificate, numerate and literate, PC literate, Excel, Word, Email. Ambulance training will be provided. Previous experience of ambulance operations or equipment would be helpful. Previous domestic experience is desirable. A CRB application will need to be made on attendance.
There is a vacancy in Uxbridge (link may not work for anyone other than me, but search for yourself on http://jobseekers.direct.gov.uk/) for one: £6.20 an hour (it actually says £6.20 a week - nirvana for Lansley, no doubt).

This is 1.97% above the minimum wage of £6.08 per hour.

No doubt Lansley thinks market forces might determine that this is too much.
Alan Henness

There are three fundamental questions for anyone advocating Brexit:

1. What, precisely, are the significant and tangible benefits of leaving the EU?
2. What damage to the UK and its citizens is an acceptable price to pay for those benefits?
3. Which ruling of the ECJ is most persuasive of the need to leave its jurisdiction?

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