OP
OP
briantrumpet
Guru
Not surprised that your blood pressure went up when you wore those.
Reform, and the death of the Tory Party
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Not surprised that your blood pressure went up when you wore those.
Psamathe
Veteran
I was thinking more about how people from big business fail to address inefficiencies. I'm not questioning whether those inefficiencies exist (I'm sure they do) just that people from top of big business have experience of big business efficiency (making profits/value for shareholders) whereas making public services more efficient might require a very different mindset.
eg from my days in business when an aspect of company work wasn't going well, look at why, etc. but fairly quickly decide it's not core focus and just stop doing it - something you can't do when providing critical services eg having a nurse drive round to separately attend individuals in their home might not be considered "efficient" but as a public service you can't just decide to stop doing it. Business can and regularly does re-focus aspects of its business 'cos it can be quicker and cheaper.
nb Big business can also be inefficient, just that if it's profitable that inefficiency is well hidden. Earlier today in a large shop/warehouse company and asked if I could do something that would have been far more efficient and they grit their teeth and in a frustrated manner said sorry as their procedures don't allow it and they've tried to have it changed as it would be much easier, faster, safer, etc. but answer always comes back as no and they have to do what they're told.
OP
OP
briantrumpet
Guru
Someone who I worked for who was a staunch Tory once proclaimed that he believed strongly in "the free market, with controls".
I don't think the 'free market controls' have kept up with how the 'free market' has evolved in the era of globalism and how IT has broken down national barriers and localised controls to prevent the extreme malign side of the truly free market from taking control from governments. That, I suppose, is what's playing out now especially in the US as Musk, Bezos, Theil and Zuckerberg cosy up to Trump & Project 2025.
Pblakeney
Über Member
Sell it as outsourcing the beds for free? 😉
BoldonLad
Old man on a bike. Not a member of a clique.
- Location
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Is that essentially how it has been “sold” ie that it is cheaper than treating them as inpatients. I have no idea if that is true, but, it is the “spin”.
Stevo 666
Veteran
Only because they are no longer in government and can't cut any spending. Let's stick to the subject, shall we?
Pblakeney
Über Member
Never heard it before. Thought I was being clever but maybe just subconsciously. 😂
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Pross
Well-Known Member
You never had any issues with them in the 14 years they held the purse strings either though. They could do no wrong.
icowden
Shaman
The problem is usually government interference "to improve efficiency". When I started as a contractor for the NHS I worked through an agency. They probably charged 25% more than I got. The Trust wanted me via an agency because Trusts are tied to government pay bands for all staff. This means that they cannot compete with the private sector, so for highly skilled IT jobs they tend to get students / people who can't get better paid work / people who are learning their skills internally to the Trust.
The next thing that happened was the end of NPFiT and the start of a new procurement project. Everything was all fine and dandy until 2017 when the government decided to make IR35 changes. At that point - no one would work for a Trust because it would be inside IR35, meaning full tax but no pension, no holidays. Completely undesirable for a contractor who can be given two weeks notice.
The Trusts therefore needed a solution. They would create a project and use a project budget to hire a company like Deloitte. That company would hire the necessary contractors. The contractors would therefore not be contracted by the NHS, and the project company would not have any IR35 obligations.
So instead of hiring me and my agency getting 25% on top, you now move to a model where Deloitte charge the agency a fee with their 25 to 50% on top, the agency still take their 25% and I still get the same contracting wage. So I get £250 a day, my agency get £75 a day and Delotte now get their £75 to £150 per day. Instead of employing me at a competitive wage, the Trust ends up moving from paying £325 per day to around £450 per day and so on up the chain - the PM probably ends up with a Deloitte charge for £800 a day, of which Deloitte get £250, the agency £125 and the PM £425.
Plus you then get government change "we are going to introduce Clinical Commissioning Groups ", " we've decided to rationalise CCGs and they will now be ICBs and ICSs - we need two seperate bodies". "We've decided to turn the Health and Social Care Information Centre into NHS Digital and expand their remit", "We've decided to abolish NHS Digital and merge them with NHS England".
All of these things cost money "well we are going to need to move the NHS Digital Systems into NHS England infrastructure as the contracts will be ending...".
If successive Governments stopped fiddling with things, the NHS would have a lot more money.
All uphill
Senior Member
Reminds me of a time when I worked for a public body set up for a particular client group.
On an away day
middle managers were asked to list their priorities for the coming year.Between us we came up with six priorities. The facilitator pointed out that not one of the priorities even mentioned the client group!
Inward looking doesn't begin to cover it.
In the FTSE 100 company I worked for every business proposal had to be linked back to the paying customer and shareholders.
Edit: this doesn't mean that I support privatisation of all public services, just that I'm sure taking services into public ownership is not a straightforward or simple way to improve them.
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Stevo 666
Veteran
Are you done with the leftie whataboutery yet?
dutchguylivingintheuk
Veteran
Well they both are, Tories are sinking since they outed Boris.
Not saying that he was great as an PM or anything, however i don't think we would have the same landslide labour victory if it was Boris vs Starmer and i also don't think Farage would have as much success as he has now.
As Farage plays into an vacuum that was left after they didn't really have an leader like Boris. (controversal, maybe not the smartest, but he will get votes)
All uphill
Senior Member
Boris went for a reason - even the Tories saw him for what he is.
It's taking a long while for the same to happen in the US.
Dorset Boy
Regular
"eg having a nurse drive round to separately attend individuals in their home might not be considered "efficient" but as a public service you can't just decide to stop doing it."
At the moment the nurse probably drives from one side of town to the other, then back then off in another direction and then back, rather than the most efficient route between patients. So there might be an easy efficiency saving there.
Having spent some time with West Australians recently, they can't understand why the UK government aren't more in favour of private healthcare and private education as it reduces the burden on the state significantly, whilst you are still paying for the state service through taxation.
Using education as an example, let's say is costs £5,000 pa for the state to educate a child. They would subsidise private education by say £2,000 pa, so the state is saving £3,000 pa on educating the child, with the parents picking up the rest of the cost. It's such a different mindset to the envy of the UK. Nationally, around 37% of students go to private schools in Australia!
At the moment the nurse probably drives from one side of town to the other, then back then off in another direction and then back, rather than the most efficient route between patients. So there might be an easy efficiency saving there.
Having spent some time with West Australians recently, they can't understand why the UK government aren't more in favour of private healthcare and private education as it reduces the burden on the state significantly, whilst you are still paying for the state service through taxation.
Using education as an example, let's say is costs £5,000 pa for the state to educate a child. They would subsidise private education by say £2,000 pa, so the state is saving £3,000 pa on educating the child, with the parents picking up the rest of the cost. It's such a different mindset to the envy of the UK. Nationally, around 37% of students go to private schools in Australia!
dutchguylivingintheuk
Veteran
Agreed but that does not take away that both Boris and Farage, and also for example Blair and Cameron(and Trump too) are poeple who attract voters easily whom despite saying at best half truths still get voters easier then others. Which is why lettuce sorry Tuss, Sunak and all the others failed. and why Badenboch doesn't seem to cut it either.
I'm convinced Trump would be elected again if they would have elections now, or let's say if they have a year from now to run campaigns (ignoring the fact he can't run for 3 terms)
Because the democrats still don't have and answer, yes i'm pretty sure Harris would have been a better choice in terms of knowledge, policy etc. etc. however at winning votes she was terrible. The democrats needs someone that can counter someone like Trump, as long as they have not, they are not likely to win.
