The coalition NHS shakeup Page 3

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  • spamdangled 27 Jan 2011 22:32:50 27,413 posts
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    Chopsen wrote:
    This may all turn out to be a waste of time.

    I was at a meeting this evening of county wide NHS bods, various chief execs, trust managers, armies of GPs and local consortia leads in waiting. Now, the jargon bit:

    Someone asked if the TUPE regulations apply to when the PCTs are dismantled and the consortia take things over. TUPE means anybody who works within the NHS means their post (inc pay, role, rights etc) is protected, regardless of what happens to their organisation. It's a bit more complicated than that, but that's the nub of it. The answer came from the local LMC guy, who'd been at a local GPC/BMA meeting where they consulted the BMA lawyers (translation: important local GP in political terms meets with lawyers employed by national GP organisation for legal advice).

    The answer to this was "Yes, TUPE applies".

    Now, this makes the whole thing completely pointless. Consortia have 3 choices:

    1. Keep the whole PCT with the same people on the same terms. Business as usual. Nothing has changed. Everything costs the same, but the route that the money takes has changed.

    2. Scorched earth. Don't have anything to do with the PCT and employ a completely new body of people who have no idea what the whole thing is about. Build it from the ground up, spend a fortune on training, compensating for inefficiencies, development etc.

    3. Force the PCTs hands to make massive redundancies. The cost of those redundancies completely fuck the PCT management budget which is already being aggressively cut. This means when the consortia take over they inherit a massive deficit and spend god knows how much public money on redundancy packages.

    Only option 1 makes any sense. Which basically "everything stay the same."


    Whils option 1 seems the most logical, I wouldn't be at all surprised at the other two, particularly option 3.

    3DS: 4055-2781-2855 Xbox: spamdangled PSN: dark_morgan Wii U: Spamdangle Steam: spamdangled

  • RichieTenenbaum 27 Jan 2011 22:33:21 2,223 posts
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    Everyone who is interested in this has to watch this short film

    http://www.spinwatch.org.uk/blogs-mainmenu-29/tamasin-cave-mainmenu-107/5417-take-a-tour-of-lansleys-private-healthcare-supporters

    They really are fucking us.
  • spamdangled 27 Jan 2011 22:35:36 27,413 posts
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    RichieTenenbaum wrote:
    Everyone who is interested in this has to watch this short film

    http://www.spinwatch.org.uk/blogs-mainmenu-29/tamasin-cave-mainmenu-107/5417-take-a-tour-of-lansleys-private-healthcare-supporters

    They really are fucking us.

    I'll have a look at it in a bit. TBH though its been obvious this whole thing is just about dismantling the NHS and handing it to the private sector all along.

    3DS: 4055-2781-2855 Xbox: spamdangled PSN: dark_morgan Wii U: Spamdangle Steam: spamdangled

  • chopsen 27 Jan 2011 22:39:48 16,126 posts
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    @starmagic

    That's pretty much how it's looking at the moment.

    There are other stuff as well, but that's being done by stealth and I have a sneaking suspicion this "giving power to the people" spiel is being used as a deflection tactic. For example, a significant chunk on county wide expenditure reduction is expected to come from providers, *before* consortia goes live in 2013. Translation: hospitals, mental health trusts, people who actually treat patients, get less money. Nobody seems to be talking about that....

    The "keep NHS public" brigade are missing the point, and are really playing in to the govt's hands imho. This is an exercise in reducing the nhs spending by distracting people's attention elsewhere. Private contractors are nothing new, and have been there for years now. Labour did more to facilitate this than these changes.
  • spamdangled 27 Jan 2011 22:42:01 27,413 posts
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    Well its not just the NHS they're fucking over. Look at education. The whole free schools bullshit. Before the election, Cameron was caught live on tv saying he wanted to hand education over to the private sector.

    Now he's saying its all about the "big society", but that public schools wont suffer.

    And yet he has frozen investment in any school that isn't a free school or academy.

    3DS: 4055-2781-2855 Xbox: spamdangled PSN: dark_morgan Wii U: Spamdangle Steam: spamdangled

  • chopsen 27 Jan 2011 22:42:51 16,126 posts
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    darkmorgado wrote:
    Whils option 1 seems the most logical, I wouldn't be at all surprised at the other two, particularly option 3.

    Why would someone chose those? Why would consortia make decision that massively disadvantage them? They're the ones making the decision. They're not going to go for the "this is going to fuck our budget from day 1" option, and they're not going to go for "lets spend loads of money trying to reinvent systems that already exist and most probably fail."

  • spamdangled 28 Jan 2011 04:03:02 27,413 posts
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    This is interesting.

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  • dnbuk 23 Feb 2011 01:34:49 4,956 posts
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    NHS to lose 50,000 jobs: http://www.guardian.co.uk/society/2011/feb/23/nhs-to-lose-50000-jobs?CMP=twt_fd
  • ecu 23 Feb 2011 01:54:39 77,031 posts
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    Can we just have another election next month? They weren't even properly voted in anyway, and labour are going to crush them in the next election. Seems like they're just seeing how much they can fuck up in the little time they have.
  • spindizzy 23 Feb 2011 02:10:56 6,542 posts
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    Has this been linked?
    Here is what politicians apparently cannot understand: itís fine to make policy based on ideology, whim, faith, principles, and all the other things weíre used to. Itís also fine for evidence to be mixed. And itís absolutely fine if your reforms arenít supported by existing evidence: you just shouldnít claim that they are.
  • Retroid Moderator 23 Feb 2011 02:24:00 45,025 posts
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    Ben Goldacre has been linking to a LOT of articles which either don't support what the ConDem gov is doing or are written by people who don't support it. Including one written by senior people in the British Medical Journal.

    Yeah. What the fuck would THEY know about healthcare, eh?
  • LionheartDJH 23 Feb 2011 12:25:25 19,492 posts
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    ecureuil wrote:
    Can we just have another election next month? They weren't even properly voted in anyway, and labour are going to crush them in the next election. Seems like they're just seeing how much they can fuck up in the little time they have.

    I'm sorry, were some of the rules of the British electoral and government system broken at the last election? This is news to me. And they're not trying to mess things up, they're trying to make it better and clear up the mess that Labour left us with. I can understand the arguments against what is happening of course, no-one likes to see public spending cuts and job losses, but to assert that they're trying to intentionally 'fuck things up' as you put it, is wrong.

    She dives for cheese pasties

  • Stickman 23 Feb 2011 12:28:03 29,666 posts
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    It's just a happy coincidence.

    THIS SPACE FOR RENT

  • TheSaint 23 Feb 2011 12:30:22 14,623 posts
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    Union-funded website reveals big job losses across the NHS

    Nice impartial source then.
  • ScoutTech 23 Feb 2011 12:37:30 2,425 posts
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    ecureuil wrote:
    Can we just have another election next month? They weren't even properly voted in anyway, and labour are going to crush them in the next election. Seems like they're just seeing how much they can fuck up in the little time they have.

    Sorry, bit of a derail as I haven't got through the whole thread, but this is what scares me. There really is no hope!
  • skuzzbag 23 Feb 2011 12:52:28 5,651 posts
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    They are trying to cut faster and deeper than is needed as they realise that what they are doing will either work, or fuck them up so badly that they will lose massively.

    So rather than a 10 year plan that most people would accept as necessary, they have to do it as a 3 year plan leaving them 1 year to grovel to the voters.

    So to be honest they are fucked whatever they do.

    They really probably should have not tried to get in at all to be honest as they are going to suffer horribly due to the deficit. That wasn't caused by Labour BTW but a result of a flawed banking system they are all responsible for creating.

    However in the meantime they can use the excuse of deficit to get rid of a few non-Tory favorites such as the Health Service.
  • LionheartDJH 23 Feb 2011 12:59:10 19,492 posts
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    skuzzbag wrote:
    They are trying to cut faster and deeper than is needed as they realise that what they are doing will either work, or fuck them up so badly that they will lose massively.

    So rather than a 10 year plan that most people would accept as necessary, they have to do it as a 3 year plan leaving them 1 year to grovel to the voters.

    So to be honest they are fucked whatever they do.

    They really probably should have not tried to get in at all to be honest as they are going to suffer horribly due to the deficit. That wasn't caused by Labour BTW but a result of a flawed banking system they are all responsible for creating.

    However in the meantime they can use the excuse of deficit to get rid of a few non-Tory favorites such as the Health Service.

    Of course the bank bailouts added massively to the problem, but Labour were running a structural deficit for years, which is what the coalition is now trying to eliminate. I can understand the logic at the time as they didn't predict the financial collapse, but it still wasn't the wisest of ideas.

    And you're right they probably are knackered, but I'd have said that if Labour had got back in again. Whoever came in was going to have to cut spending and jobs and that obviously never goes down well.

    She dives for cheese pasties

  • TheSaint 23 Feb 2011 13:00:54 14,623 posts
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    You all seem very confident that Labour will win the next election. IMO Ed Miliband will get crucified by the media and will be Labour's William Hague.
  • thelzdking 23 Feb 2011 13:17:05 4,369 posts
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    The roots of many of the problems that this country is now facing stretch back many years and are the responsibility of both Tory and Labour governments.

    Of course the patronising narrative that the media (and politicians) choose to put forward doesn't allow for the complexities and levels of subtlety that exist in the real world.
  • Khanivor 23 Feb 2011 13:27:26 40,951 posts
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    How many new staff did the NHS acquire during Labour's tenure?

    If folks are going to assume evil Tory ideology to destroy the NHS is at play then perhaps they could take a moment to consider the figures in the light of gallant Labour ideology of stuffing the public sector with employees as if they were on a game show?
  • disusedgenius 23 Feb 2011 13:34:55 5,431 posts
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    Khanivor wrote:
    gallant Labour ideology of stuffing the public sector with employees as if they were on a game show?
    Wasn't the issue more with over-management and private consultants? If we're going to attack a Labour ideology then the extent of state control and oversight is far more worthy than them hiring a lot of nurses. :)
  • chopsen 23 Feb 2011 13:38:25 16,126 posts
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  • chopsen 23 Feb 2011 13:40:59 16,126 posts
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    Aye. Labour justified themselves for more than one term by saying they were dealing with the consequences of the Tories' fuck-ups. Saying our current situation wasn't labour's fault but the flawed banking system is a non sequitur as they could have reformed the banking system. In fact they just carried on the work the tories had started in freeing up the financial industry and increasing our dependence on that and a few other narrow service-based industries for our economy. Anybody who thinks the tories would have done any different should bear in mind that they started this way back when with Thatcher, and a lot of what she did was due to the need to move away from being dependent on industries that were exploited by the unions to form their own power base. And guess which party oversaw that?

    @LDJH, a lot of the stuff your saying sounds like vertabim soundbites from Tory party propaganda. It's a bit more complicated than that.

    And the Tories *will* fuck it up, because to a certain extend the political industry we have dictates it (there must be change, it must be massive, and it must tie in with the general election time table)
  • Khanivor 23 Feb 2011 13:45:25 40,951 posts
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    @dg - too right; it's interesting to divine from the numbers on that website that most staff being fired don't seem to be doctors and nurses.

    Also, can someone with experience of working in the NHS say how close to retirement the majority of part time doctors tend to be?
  • LionheartDJH 23 Feb 2011 13:46:10 19,492 posts
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    Chopsen wrote:
    @LDJH, a lot of the stuff your saying sounds like vertabim soundbites from Tory party propaganda. It's a bit more complicated than that.

    And the Tories *will* fuck it up, because to a certain extend the political industry we have dictates it (there must be change, it must be massive, and it must tie in with the general election time table)

    Of course I understand things are more complicated, perhaps I should qualify some of my posts with 'in general'. I do try to see different sides to an argument.

    I can see what you're saying there. Obviously I hope not and that things work out, but as pointed out they are taking a gamble, and it could backfire if not managed right or their predictions were wrong.

    She dives for cheese pasties

  • chopsen 23 Feb 2011 13:51:57 16,126 posts
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    LionheartDJH wrote:
    but as pointed out they are taking a gamble, and it could backfire if not managed right or their predictions were wrong.

    Exactly. So why not trial it one area first? Oh yeah, because that means it will take longer than 3 years.

    Stupid stupid stupid.
  • Khanivor 23 Feb 2011 13:55:13 40,951 posts
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    It is retarded to not try these ideas put in isolation first. Some kind of explanation as to why they aren't doing this would be grand.
  • disusedgenius 23 Feb 2011 14:00:38 5,431 posts
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    Staggered elections so you have a slowly evolving parliament rather than a fixed one.

    That'd be fun.

    /ponders the ways that would fuck up the country
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