O/T:- The NHS strike - for or against?

[Elite_Pie]

I’m happy to support nurses getting more pay, but the resources need to be released from within the system, not by throwing more money at it. The NHS is a huge unwieldy beast that needs to be divided into smaller, more manageable segments, regardless of whether those segments are state-run, privately run or both. It’s encouraging to hear even Labour folks like Wes Streeting acknowledging that the NHS needs reform, because treating it as sacred cow won’t do the organisation or the public any favours.

Some very detailed answers there jackal (when is your second novel out!), but I agree with the bit I've quoted. If the waste and mismanagement was sorted, it would probably fund a 100% increase for NHS staff across the board.

It's really a separate issue to this strike, but it's definitely been a main contributor to the problem.

[jackal2]

Some very detailed answers there jackal (when is your second novel out!)

If you've ever seen Dave Gorman's Googlewhack Adventure, then my motivation and discipline to write a novel is on a par with his!

[magpie_mania]

I think we can agree on that.



Easily countered by asking why the government won't enter discussions. Why do you think?

They won't enter discussions about pay. You say it's not about pay, so what is stopping them getting together?

[Elite_Pie]

They won't enter discussions about pay. You say it's not about pay, so what is stopping them getting together?

I didn't say it's not about pay, I said it goes much further than being solely about pay.

As to what's stopping them getting together, maybe you should ask Rishi Sunak rather than me.

[BigFatPie]

I don't think nurses are greedy at all. My point was lots of people feel they should be paid more, particularly given the increased cost of living, but don't have a mechanism in place to demand it.

Entirely correct. Join a union.

[OchPie]

I’m happy to support nurses getting more pay, but the resources need to be released from within the system, not by throwing more money at it. The NHS is a huge unwieldy beast that needs to be divided into smaller, more manageable segments, regardless of whether those segments are state-run, privately run or both.

I think the best response to this is the very decentralised (and hybrid public-private) social care system, which has been for years a complete disaster.

No it isn't. It's free at the point of use, except where you pay prescription charges, but ultimately the NHS is funded from the public purse, so we should all be keen to see the money we spend on it being used as efficiently as possible. It isn’t at present.

You can't cut your way to efficiency though. One big issue with the Tory starving of the NHS has been the knock-on impact on care quality, which the system then has to scramble to fix. (Of course the starting point, the health of the nation, plays into this too - but the Tory love of selling off playing fields plays into that as well.)

Look at the lack of capital expenditure. This means patients get in and out less quickly. Inefficiency.

The NHS has actually been massively funded, but it's a bottomless pit - a hopelessly outdated and impractical operating model. In that sense you're right - there needs to a completely different way of thinking about the way it's funded in future and some people might indeed not like it, which is why politicians on all sides won't grasp the nettle and keep hiding behind platitudes about ‘our wonderful NHS’, but eventually it will just collapse under its own weight. In fact it already is.

This just doesn't match the historical record. Fund the NHS like a contintental healthcare system and it provides care of the quality of a contintental healthcare system - Labour proved that.

I do agree that it's good to have an honest conversation about the advantages and disadvantages of the NHS system, but I see no evidence the NHS system couldn't be fit for purpose. The key advantage for the wealthy right in pushing other models is that care rationing - which EVERY health system does in one way or another - EVERY healthcare system is a bottomless pit because demand has no limit - shifts away from clinical need and towards individual ability to pay.

There are ways around that too. The Swiss system works pretty well, all told, in outcome terms. But it's extraordiarily expensive in European terms and has massive inequality issues, with poorer Swiss actively avoiding healthcare checks due to the cost. That has to be a political decision ultimately. The NHS still does amazingly at providing low income adults with care, by design. Making a decision to stop doing that should be properly articulated.



Reform is definitely needed - though one of the biggest drivers of inefficency in the NHS is that reform hasn't stopped there in decades, often seemingly for its own sake.

Additionally: managers stop front-line healthcare workers from having to do admin and allows them to get on with healthcare. That point seems to elude many, unfortunately. The Tories in the coalition government slashed the number of managers - it's now about 2% of the NHS workforce. That number is far, far lower than the national average of ~10% - which is also the level of most large, successful organisations.

As for the nurses - if this were a free market I think they'd already be getting far more than 19%. The UK relies on foreign healthcare workers and the competitiveness of the UK in that market has absolutely tanked. Meanwhile the UK has made it harder for British HCWs to get trained. So with massive demand for labour, supply is already shrinking. Shifting to a different system doesn't change that reality - but British nurses with private sector market power, like their foreign colleagues, I suspect would be in a far better position to extract money than those with public sector rights to strike. Be careful what you wish for.

[BigFatPie]

[GranthamPie]

Excellent synopsis OchPie

[Magpies1959]

Elite_Pie, for the first and last time, I do not read the ****ing Daily Mail, and has anyone ever told you that you are a patronising g*t.
I,along with everyone on the message board, I am assuming, would just love an NHS that is financially viable and treats and cares anyone who has paid into the system, to a level that everyone is happy with (staff and patients). This will only become achievable when we have learned how to knit fog, I fear.

[Elite_Pie]

Elite_Pie, for the first and last time, I do not read the ****ing Daily Mail, and has anyone ever told you that you are a patronising g*t.

I'm sure they have, but I don't see that it applies here. You posted a pack of lies, I simply corrected them.

I,along with everyone on the message board, I am assuming, would just love an NHS that is financially viable and treats and cares anyone who has paid into the system, to a level that everyone is happy with (staff and patients). This will only become achievable when we have learned how to knit fog, I fear.

I think we all know the NHS will never be perfect, but it doesn't have to be in the pitiful state the Tories have reduced it to.