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[albitz]

I think your probably right Kevin and I think Nickbat has probably provided at least part of the solution.The u.s. has a lot going for it imo,but afaik you really dont want to be a poor person living there and get ill,If you cant afford the insurance then you wont get much in the way of treatment ,.

I'm not wholly convinced on that A - it'll require some more thought.  It's a very complex body to organise on such a parochial basis,

Funding will always be the issue and the administration of those funds will be the potential stumbling block to such radical reform.

IIRC it used to be organised in a similar parochial fashion and it seemed to work a lot better than it does now.I think ,as Ljay suggests the problems mostly lie in the upper echelons - the "professional managers"and bean counters etc,it somehow needs to be put back into the hands of people who have the patients right at the top of their list of prioroties imo.

[Nickbat]

I think your probably right Kevin and I think Nickbat has probably provided at least part of the solution.The u.s. has a lot going for it imo,but afaik you really dont want to be a poor person living there and get ill,If you cant afford the insurance then you wont get much in the way of treatment ,.

I'm not wholly convinced on that A - it'll require some more thought.  It's a very complex body to organise on such a parochial basis,

Funding will always be the issue and the administration of those funds will be the potential stumbling block to such radical reform.

Questioning me eh, Zulu? That will never do! 

Seriously, though, the work of a school governor (in my experience) is precisely what the NHS needs. Governing bodies are not concerned with the day-to-day running of a school, but make senior appointments and take executive decisions as to the direction of the organisation. They also have to approve expenditure and accounts. They do not do so with an eye to their own pecuniary advantage, or to furthering their personal careers. Decisions are taken (or should be if the GB exercises its powers correctly) with the aim of providing the highest quality education at the lowest price, but with former taking precedence over the latter. Just think how our boys in Afghanistan would get on if a similar principle was employed at the MoD!
    

[LJay]

I think your probably right Kevin and I think Nickbat has probably provided at least part of the solution.The u.s. has a lot going for it imo,but afaik you really dont want to be a poor person living there and get ill,If you cant afford the insurance then you wont get much in the way of treatment ,.

I'm not wholly convinced on that A - it'll require some more thought.  It's a very complex body to organise on such a parochial basis,

Funding will always be the issue and the administration of those funds will be the potential stumbling block to such radical reform.

The NHS makes too many people, too much money for there to be any reforms!

I did the same job for 3 different NHS trusts in 2 years, each time there arrived a different set of managers, a different set of stationary, a different set of rules and training etc.. all costing god knows how much!

...it always comes down to money in the end Lj and this is why change will will be very difficult to implement - sadly.

Certainly does! I've been asked many times to return to the NHS and I've declined, it's about the money not the patients, hence these jobs will be lost from frontline staff not pen pushers!

[albitz]

Sadly Ljay,your probably right.

[Dishevelled Den]

I think your probably right Kevin and I think Nickbat has probably provided at least part of the solution.The u.s. has a lot going for it imo,but afaik you really dont want to be a poor person living there and get ill,If you cant afford the insurance then you wont get much in the way of treatment ,.

I'm not wholly convinced on that A - it'll require some more thought.  It's a very complex body to organise on such a parochial basis,

Funding will always be the issue and the administration of those funds will be the potential stumbling block to such radical reform.

Questioning me eh, Zulu? That will never do! 

Seriously, though, the work of a school governor (in my experience) is precisely what the NHS needs. Governing bodies are not concerned with the day-to-day running of a school, but make senior appointments and take executive decisions as to the direction of the organisation. They also have to approve expenditure and accounts. They do not do so with an eye to their own pecuniary advantage, or to furthering their personal careers. Decisions are taken (or should be if the GB exercises its powers correctly) with the aim of providing the highest quality education at the lowest price, but with former taking precedence over the latter. Just think how our boys in Afghanistan would get on if a similar principle was employed at the MoD!
    

    Yep I'm a tad reluctant to get into this too much at the moment as I haven't done much research.

What is plain is that there has to be some change, what it is I don't know.

Effective, coherent administration of such a complex body will require some very strict, clearly defined regulation if there is to be any success at all.

[Banjax]

the NHS isn't perfect, and like a lot of large companies, generates a lot of waste

too many managers, not enough frontline staff

comprehensive healthcare, free at point of delivery to all - that's something we want to get rid of?

and i love these business consultants - how exactly do you get paid to come up with the idea that cutting 137000 would save you money?

where do they get these Olympian minds from? such genius! who'd a thunk it? cutting jobs!! of course!! why did we have to go and spend £m's on business consultants, in order for them to tell us to pay less people!! actually on that subject has a business consultant, in any way, shape or form ever actually advised anything other than cutting jobs? seems like the biggest crock since organised religion if you ask me 

[bertiecbx550]

It was study done by a private consultancy firm and they said the NHS would have to cull 10% of its workforce including front line staff to meet the planned £20 billion in effiency savings by 2014....Now do you honestly think they will do this?

[jereboam]

The NHS isn't as good as it could be, and it isn't as good as it should be.  But it has to be worth persevering with it. 

"Private companies" isn't the answer.  They still have to be paid by someone, and that means private insurance.  But you can't just convert nationwide fully funded medical services to private insurance.  As someone has already pointed out, some people will be uninsurable given their current age and state of health.  Medical insurance premiums are calculated on the basis that the proposer is healthy and that all existing medical conditions have been declared (which effectively means that cover for them is excluded or that premiums are loaded).  They are related to age, so anyone over 55 will have to pay a very high premium, and anyone over 75 is likely to be declined.

So what happens to the uninsured?  Probably the government will have to pick up the tab.  Insurance companies will love that - what an opportunity to inflate their premiums!  Buy insurance shares now. 

As to the management/clinical staffing issue, there's no easy solution there either.  I'm sorry to say that the consultants working in the NHS these days are not in any way trained to take on the management functions that are necessary to run any part of the sort of health service we need.  They are (mostly) capable clinicians, but even restricting the argument to that area only, they are too often lacking in the requisite people skills. 

Of the managers and administrators, to put it politely, one sometimes wonders whether they have the skills needed.  We get cross about the banks paying extortionate sumes of money to their managers, but the "pay peanuts, get monkeys" rule applies across all sectors.  Not that NHS managers are paid peanuts - they are quite well rewarded these days, but not to the extent necessary to attract first rate people.  I feel that NHS HR people and the various selection committees are a significant part of the problem.  Too much PC and office politics, resulting in the appointment of people who are utterly incapable of doing their jobs.

And don't even mention the clowns responsible for the enterprise IT plans.

As an elderly, obese, deaf diabetic with asthma, high blood pressure and high cholesterol, not to mention another half dozen minor chronic complaints, I have had to spend quite some time in the hands of the NHS.  It ain't as bad as it's painted, but, by heaven, there's plenty of room for improvement.

[STMO999]

According to the BEEB this morning it's front line staff that are in the firing line. Both the major parties have didmissed the report but, with a general election next year, they would, wouldn't they?

[HolyCount]

Save money in the NHS

Fire half the managers.

Prepare simple well cooked meals (not Lloyd Grosman concoctions -- when you are ill you don't want your food to be messed around with). Charge a quid a day (you pay for food at home, why not at hospital?).

Bring cleaning back in house where it can be better monitored and somebody isn't making a profit on it.

Deliver what it was set up for -- relief of pain and suffering. Not fertility treatments and nose jobs.

Stop hanging expensive pictures on the walls -- it's a hospital, not a hotel!

[Nickbat]

Save money in the NHS

Fire half the managers.

Prepare simple well cooked meals (not Lloyd Grosman concoctions -- when you are ill you don't want your food to be messed around with). Charge a quid a day (you pay for food at home, why not at hospital?).

Bring cleaning back in house where it can be better monitored and somebody isn't making a profit on it.

Deliver what it was set up for -- relief of pain and suffering. Not fertility treatments and nose jobs.

Stop hanging expensive pictures on the walls -- it's a hospital, not a hotel!

I'd better book up now in case your ideas are accepted, HC!