So yesterday 20000 doctors protested in 3 UK cities over the new contract the DoH has demanded they sign up to. The media coverage of the issues appears to be somewhat schizophrenic, so I was wondering what public perceptions of the issue were?
I have not been able to determine whether this is intended to improve quality and/or reduce cost - but it seems futile right now, given the mess that the UK NHS is in. However if in the UK, you can see this on iplayer - someone has removed the disturbing audio to this on the youtube that is available worldwide. @5.17, the commentary tells you all you need to know regarding the future NHS - we are currently spending £400 million every day - this is not sustainable. Exactly where the idiocy of a 7 day week Doctors contract fits into transforming the NHS into something functional and affordable is unclear. http://www.bbc.co.uk/iplayer/episode/b05y3fcb/panorama-nhs-the-perfect-storm
We spend on average £3000 per year per person less on healthcare than virtually every comparable country. What's unsustainable? Also until 2012 most trusts ran at a small surplus, suggesting the problem isn't internal.
Indeed France & Germany - the 2 most comparable countries do spend a lot more on healthcare than we do Economically we are just about swimming with our heads out of the water. France is practically bankrupt. The word I hear from Germans, is that their system is crumbling - I heard of a hospital in Aachen making 20% cuts on all salaries except for Doctors - and I know 1 German Doctor who tells me that German Doctors want to work in the UK - because the working conditions are better - however this was before 7 day week contract. Germany is 'probably' equivalent to us economically now - although it is not comparing apple with apple - our economies, strengths, weaknesses and complications are different - they are our nearest equivalent though. Netherlands where I spent all of last year, have fully privatised their health system - that took 30 years of legislation. I think if you are dirt poor, you can avail of some basic care in the Netherlands still. In the UK we have vast infrastructure re-engineering costs to quantify, we are involved in a few stupid wars, that will be difficult to exit from cleanly. We have to decide if we need Trident nuclear deterrent replaced - conservatively estimated at £100-130 billion - I think this is ridiculous but I have no military intelligence to assess the real risk. If you watch that iplayer programme, all the interviewed people state that our NHS cannot continue as is. Also stated is that our NHS costs more than our entire armed Forces budget. Is that sustainable or unsustainable?
It does seem to have become much worse in the last few years. However, I cannot make any analysis of 'suggestions'. Until there is hard evidence, it is difficult to be sure. As there is practically zero political opposition to the current Government, I am not waiting with baited breath. I read that 18 million people tuned into 'The Great British Bakeoff' - I do not believe that the UK populace cares enough about the NHS or other political matters, to make 1 jot of difference to how the current Government operates.
The NHS can't survive as it is, which is the aim of government policy. The government has also slashed defence spending, so comparisons with health are not necessarily useful, but as the NHS is the single biggest government employer you'd expect it's budget to be larger than others. If the status quo is unsustainable, how did the government feel able to cut 5% off the top rate of tax, raise the inheritance tax threshold and cut corporation tax? It's a purely political decision not to adequately fund the service. Demand has increased by 4.5% per year and funding has increased by less than 1.5% per year, coupled with a catastrophic under-investment in training and recruitment.
If the Bond investors that fund the Nation's debt demand these economic policies out of the Tolleys or their predecessors or successors; it is a price we will have to pay. The Tolleys won the last election fair and square - and opposition looks a lot weaker. So ask yourself, what will change? Why do the medical folk in the player programme state that the system is unsustainable? I do not have answers to any of this, but I smell a grain of truth in what the Medical Folk in Liverpool are stating in the player programme, uncomfortable as it is. The BBC is not known for right wing ideological broadcasting.
From various folk that I have known working in the NHS, they state that matters were ok, until PFI and Compulsory Tendering came in to the NHS, ushering in new layers of expense and bureaucracy; so probably simplifying this would help to reduce cost. I cannot see what a 7 day week contract will achieve.
Context. It is unsustainable as is. It needs a massive cash injection, which is why the government are being told that the £8billion extra they've promised this term needs to be front loaded. People need to decide what they want. The cost of a US style funding system will be more than an extra 1p on income tax for the vast majority of the population (probably anyone earning less than £150000).
As stated already, I do not see any visible sign of the UK populace opposing the Tolleys. Even in Scotland, polls show that we Scots are unwilling to raise taxes up front, hence the SNP will not oppose the current cuts - just like Corby's Labour Party experiment. So where will this massive injection come from? Trees growing in a £ orchard? The Labour Party even went to the bother of consulting Pikkety and Stieglitz on final planning - only to tamely agree to the Tolley cuts i.e we have to see some indication from where this 'massive investment' will come from. Economic growth looks to be impossible right now.
A) doctors already have a 7 day week contract B) Having worked in the health service for a very long time I can assure you this isn't true. PFI has turned out to be a very bad deal, but it came about because of the decade of under-investment that preceded it. The feeling in the health service in the mid 90s was very similar to what you see now, and that was before the added pressure of house price inflation. Indeed, most of the huge progress the health service made in the noughties has been entirely undone (long A+E waits, long operation waits, long outpatient waits, difficulty getting a GP appointment). You're right, there are large savings to be made by scrapping the internal market, and buying out PFI contracts, but it must be remembered the NHS is consistently rated as the most cost efficient health care provider in the world, and that healthcare here costs nearly half what they are elsewhere, so efficiency savings are limited. Indeed, many of the current inefficiencies are caused by previous efficiency savings making the service less responsive and adaptable.
A) large investment in the UKs largest employer would likely cause economic growth. B) the government have cut numerous taxes while consistently failing to meet their own deficit reduction targets, so again it's a straight political choice. C) The amount of money poured into the banking sector with very little in the way of safeguards in return and ongoing cost to the taxpayer represents over 10 years worth of NHS budget. Public assets have been sold off at well below market valuations. Replacing a missile system we'll never use will cost more than the annual NHS budget. We've given 56 billion pounds to private American companies to develop a fighter aircraft that may never enter service and if it does has already been cloned and bettered by the Chinese. There's plenty of money floating around in government, it's about how they choose to spend it.
I agree with almost everything you stated - except this. Governments of any country can either tax their citizens and/or raise borrowed funds through Bond auctions. As the Bond market is perceived as over priced and very risky by Investors, Brokers and Banks; with a growing problem of liquidity - available cash exchange in trade; made worse by serious concerns about China's ability to fund our Western Bond programmes - about 30% of UK Gilt edge Bonds are funded by overseas investors - the vast majority of which are Chinese; raising funds through re-financing Bonds is unlikely to prove profitable for the Bond issuer i.e. the UK Government; shifting the burden of investment onto taxation - which is much more difficult to a) make popular and b) obtain the volume required. We are where we are, and yes, it is largely politically motivated by the Tolleys & their chums - but they were elected - surely no-one was surprised by their policies? Worse still, I cannot recall a time when left leaning parties in the UK and in Europe were weaker in my lifetime. So in summary - I have to deal with some other matters this Sunday - I see more chance of rain stopping in Scotland and the Pope converting to Islam than real and effective a) opposition and b) reversal of pretty much the entire Tolley programme for the foreseeable, lets say next 10 years at least,
I don't know, the Conservatives only have a 12 seat majority, and 71 of there MPs have majorities that are less than the number of their constituents who are adversely affected by the tax credit cut. Now it's difficult to know how their vote spread was, but we know from Question Time that at least some of them voted Conservative, and the vote of the working poor is an important one for the Conservatives. Labour is far stronger now than it was in May, and the Conservative victory was so slim that one report posited that if 1500 specific Green voters had voted for Labour there'd have been a Labour majority, and one of the groups that Corbyn specifically appeals to is socialists who voted Green in the past.
I'm not in the least, but several people who did vote for them appear to be. This is why the right wing dominance in our press is a bad thing. [ame="https://www.youtube.com/watch?v=G9NPF1iXBjw"]BBCQT: Woman angry at Tories tax credits cuts (15Oct15) - YouTube[/ame]
This interview more or less sums it up:- The Tolleys biggest banana skin is likely to be due to destroying their own tribe, than by any explicit action, tactic, strategy, position or policy of any of the other tribes.
Totally, they get power by convincing people they're not evil, uncaring social elites. The trick is pinning them down and showing it.
I think its more along the lines of, folk get convinced that they will join the 'successful' Tribe. The problem for left leaning parties, is they cannot present a credible economic plan acceptable to Bond investors, Banks etc that informs the populace of its merits, such that they will vote for it. As for the media and 'bias', I do not buy this claptrap, beyond the obvious idiocy of rags like the Daily ToeNails (Daily Mail and Express) pandering to the largely uneducated who do not care that much. We had all this last year in Scotland, with media 'Bias' - and polls show continued opposition to Indy referendums. As far as serious journalism goes:- the BBC - slightly left leaning of centre. The Independent and Guardian - well to the left. The Telegraph - well to the right. The Times slightly to the right of centre. The Financial Times seems to me like the nearest to centre, unbiased and uninterested in Politics beyond how it affects Financial Markets.
The Daily Mail was reckoned to be the most influential newspaper in the last election, which is all kinds of scary.
