 |
| England 2020 |
Nursing care for the elderly has become expensive and poorly administered.
The Royal Mail has deteriorated year by year.
Public libraries are closing down, and public swimming baths are increasingly a rarity.
It is difficult to find a good NHS dentist.
I know that I must sound like Cassandra, prophesying doom, but this is the way that all public services are beginning to go. In the next five years we will see the fragmentation of the NHS into small component parts, with the profitable bits being fought over, and the unprofitable bits being left to wither in a contracted public sector.
If you want parallels in the past, you don't really need to look beyond the Railways or the Royal Mail. Privatisation has eviscerated both of these services, as the owners of private franchises make merry with our money, the service to Joe Ordinary gets worse - month by month. The hapless bureaucrats who are supposed to regulate the system seem incapable of serving the common good.
Whilst David (Call-me-Dave) Cameron starts playing the role of the statesman, his henchmen at home are preparing for a carve-up of the remaining public services. The eloquent Polly Toynbee begins to lay out the enormity of the plans in her piece in the Guardian (omitting the role that she and her apologists had in preparing the way with the disastrous "New Labour" experiment.)
First they came for the Railways. I did not complain. I had a car.
Then they came for the Post Office. I did not complain. I live in an urban area.
Then they came for Care of the elderly. I did not complain. I was not elderly.
Then they came for the Public Baths. I did not complain. I did not swim.
Now they are coming for the schools, Universities, the NHS, the remaining public services.
I am complaining.
Is anybody else?
[Apologies to Martin Niemoller]
43 comments:
‘All that is necessary for the triumph of evil is that good men do nothing’
Guilty as charged JD (supposing that I was "good" to start with).
I think that we are all a bit guilty, what with all our other "problems" caused by the Piss Poor Policies of Dave C and his sideboard of multi millionaires and the Bankers.
Better late than never though.
Polly Toynbee may be eloquent but she is full of s**t. I have no time for her hypocrisy or that of her leftie friends.
Angus, the "problems" have been and are caused by politicians of all colours and persuasions. This of course is something that lefties rarely accept as they always know better.
Very worrying JD that you are now showing your true political colours. The decay of the NHS (and the other organisations you quote) started long before Cameron/Clegg. And, as Matt implies, anyone who can quote Polly with enthusiasm must be intellectually bankrupt.
What is you evidence that teh railways have deteriorated since/because of privitisation? All the indicators show the complete oposite. This is also teh case for telecoms, electricity,gas water, BAA, BA etc etc.
I thought you wwere a doctor that took an evidence based approach to your ananlysis. Clearly not. This is just left wing politcal prejudice.
Good post. Polly Toynbee has been producing some stellar articles as of late.
GPs are about the only people who can stop the privatisation of the NHS through non-cooperation with the reforms. However GPs seem to be signing up en masse to become commissioners.
A Pulse article on changes to GP pensions attracted 100s of GPs signing up in a matter of days, threatening to take action/to quit over changes to terms and conditions.
Yet when it comes to the privatisation of the NHS, it seems the GPs can't be bothered to take a stand. Do GPs really only care about their paypackets these days?
I have disagreed a lot with Polly in the past (see posts Passim). On this she's right.
Try travelling abroad George Wright, and then come come and be ashamed at the cost and the quality of our rail system.
That is what I call evidence.
Anonymous 16:40
Please tells us what your job/profession is and of course you are ready and prepared to risk your career and livelihood for the greater good?
The Public (Good), Private (Bad) argument is outdated and irrelevant.
And Polly is a stellar a***hole.
JD
the post office is still public sector, you can blame the crap service on the shit public sector management of it
the NHS is mainly still public sector and the service is shit and sub 3rd world
you really turning into some fucking left wing nutter now
who owns the providers matters less than whether the end consumers have choice and can take their business elsewhere, it is monopoloy provision that drives down quality
yes this country is fucked, but mainly because immigration is out of control, all of the political parties are selecting candidates from the same unrepresentative small sections of society, and all politics has become too PC and far too similar
no one
The introduction of other "providers" in mail delivery has eviscerated the effectiveness of the Post Office. That is my point.
Going on the odd journey abroad is not 'evidence' it is anecdotal. (try using the German health service BTW and the anecdotal evidnece is that the NHS is terrible system)In any event teh issue was, I believe, the effect that privitisation has had on BRITISH railways. Railway performance (usage, investment, performance even sandwiches0 have improved out of all recognition since privitisation. This is true in nearly all other privitisations.
The reasons 1)No govenrment restrictions on investment and 2) Competition.
Your argument is, I reitterate based on political prejudice and not on rational evidence based analysis. Call yourself a doctor!
The introduction of other "providers" in mail delivery has eviscerated the effectiveness of the Post Office. That is my point.
We see what's going on here, JD. A change of government to a party of which you don't approve and, suddenly, Polly speaks the truth. As "no one" points out, that you are, sadly, a closet leftie. And now you have come out. The "introduction of other providers" has demonstrated just how crap the Post Office has become. The only way a Jobbing Doctor approved organisation can survive is by enforcing a state monopoly. "No-one" is right, comrade doctor. Stick to matters medical, comrade, you are completely out of your depth on politics.
What matters when it comes to it is how change/privatization is managed.
The same incompetents who mismanage the Public sector invariably contract out services to the Private sector ensuring that we get the worst of both worlds.
I fervently believe in Social Medicine but the Private sector can and should have a role in it's provision.
Thank you, gentlemen, for the lectures.
I am not overtly political, nor closet anything.
I will always be OK as I have transferable skills as a medic. The people who suffer will be the ordinary folks that I see, day in day out, in my surgery.
I do call myself a doctor.
I see much prejudice from the other side of the argument as well.
"The people who suffer will be the ordinary folks that I see, day in day out, in my surgery."
But our patients are suffering now, due to your sainted Polly and her (your)leftie ilk!
bollocks
i have transferable skills, and have earnt myself and the country a fortune
but the last and this government have run open doors immigration and printed work visas like confetti
ICT visas are still excempt and many gain indefinite leave, there are many loopholes
my industry id dead because the governments have allowed swamping of the workforce with mainly Indian nationals who fill up the schools and hospitals with their families and pay less tax than brits due to many dispensations they get
if it can happen to me it can happen to you
transferable skills is not a defence
think again
JD,
On reflection, you are comparing the Conservatives/Coalition to the Nazis.
Shame on you! The argument is lost.
That'soffensive
All I am asking for is evidence and rational analysis to back up the opinions your have put forward on privitisation- railways/ post office etc. I see none. I am left therefore to conclude that your opinions are based on (political) prejudice.
Fewer deliveries. Overcrowded expensive trains.
I suppose that the right resorts to simple mud slinging and denial instead of proper discourse.
Peter, there is plenty of "proper discourse" on this thread. Whenever there is a clash of ideologies, emotions run high.
Are you going to enter into the discourse or just sneer in a superior way from the sidelines?
"the Private sector can and should have a role in it's provision".
Why?
I mean do you have any evidence that standards will improve beyond a better deal for self selecting groups who have more buying power in the market place (the inevitable end game when clinical activity is incentivised by profit).
As JD says privatisation has hardly been a roaring success in other spheres
http://www.european-services-strategy.org.uk/outsourcing-library/contract-and-privatisation-failures/privatisation-failures/
a&e charge nurse
Why not? I am not in favor of selling off parts of the NHS to the Private sector. I'm talking about buying services in.
Oh! To steer the middle course between the political polemicists. As a long time reader, I’m saddened that the JD has abandoned objectivity but, as he has, he should be aware that, in the way he occasionally emerges from his CD collection and his well-kept garden to pass judgment on the perceived Tory threat to health care, he now comes over as a latter-day Marie Antoinette. Meanwhile, from the other side, the fascist hyenas of the blogosphere, at their two-dimensional worst when their orthodoxy is threatened by closeted, suburban, Guardian-reading, middle-class champagne-socialists, are mobilising for what they perceive to be a turkey shoot of effete middle-brow intellectuals. (Is ‘middle-brow intellectual’ an oxymoron? – but you know what I mean). Only, as so often, a shaft of common sense from the A & E charge nurse. No reason why the NHS should not commission services from the private sector provided always it does so after ‘due diligence’. No reason why the NHS, however much it does/does not use the private sector, should not remain firmly in the hands of the country. The politics do not matter. What matters is the quality of health care, not the methodology used in achieving that quality. I reach the inescapable conclusion that the JD is now attacking everything because he does not like the current government. Does he therefore – for this is the implication – suggest that all is well with health care and that the government should leave the NHS alone? Is he really happy with the ‘status quo’? If he is not, he should put forward some concrete proposals for consideration – if he has any - rather than moaning about all that others suggest.
Realist.
"Matt said...
Why not? I am not in favor of selling off parts of the NHS to the Private sector. I'm talking about buying services in."
Yes because the buying in of private cleaning services by the NHS has really been an overwhelming success hasn't it Matt?
'Buying in' is very much a feature of the coalition's vision ("any willing provider").
In my experience that most important principles driving such an approach seems to be;
*cheapest tender (although services may not prove necessarily cheaper in the long run).
*reduced level of service.
*less qualified staff.
We have already had a flavour of this when 'out of hours' GP services were contracted out.
http://www.drrant.net/2006/10/sercos-shite-out-of-hours-sooh.html
What is it you think private firms can offer that the NHS doesn't - I mean can you be specific when comparing like with like because so far the evidence suggests the privates are both more expensive, and more importantly, less clinically effective than existing NHS care (when we look at surgery, primary care and radiology)?
http://lookafterournhs.org.uk/wp-content/uploads/independent-sector-treatment-centres-oct-091.pdf
http://www.guardian.co.uk/commentisfree/2009/oct/15/nhs-private-treatment-centres
"Yes because the buying in of private cleaning services by the NHS has really been an overwhelming success hasn't it Matt?"
And whose fault is that do you think?
"Yes because the buying in of private cleaning services by the NHS has really been an overwhelming success hasn't it Matt?"
And whose fault is that do you think?
It comes with the territory of 'buying in services' where costs are continually cut to make the bosses a nice profit and staff have no sense of personal investment in their work because they are treated like rubbish by private sector employers.
Hospital cleaning was efficient and the job was done competently by NHS cleaners prior to the contracting out to the private sector for cleaning services.
Your wish to buy in more services from the private sector will only see more of the same and it's the patients who will lose out, not that you seem to care.
Realist "No reason why the NHS should not commission services from the private sector provided always it does so after ‘due diligence’. No reason why the NHS, however much it does/does not use the private sector, should not remain firmly in the hands of the country. The politics do not matter. What matters is the quality of health care, not the methodology used in achieving that quality."
Please bear with me here as I am a learner, but also someone who doesn't have a grudge against private sector. So, please explain;
1- Where is the evidence that such involement will be achieved with "due diligence" and not actually go bottoms up to the point of no return in That White Paper?
2- I too believe that yes, private sector involvement in the NHS is good providing the NHS remains firmly in public hands, however, that doesn't seem to be the case with The White Paper, as it seems to be after full privatisation?
3- No clear policy for staff training; this paper, despite it being huge, did not put clear national policy for training. This will lead to fragmented doctor training, for example. Hence, in the future we'll have some docs more favoured than others simply because of where they trained and not their ability! Unfair! And given the current selection shambles and the forever shrinking number of training posts, this downright unjust and will hurt the future of medicine in this country too. Crazy!
Like Matt I am broadly in favou of more private sector involvement in running the NHS. Something similar to the railways where the infrastructure, i.e. hospitals and health centres, remain publicly owned but service provision and employment is in private hands. For far too long our public services seem to have been run for the benefit of staff rather than those whon use them. At least this Government is trying to redress the balance, making a start with pension schemes. I'm not optimistic over the short term though; I'll carry on paying my BUPA subscription!
"For far too long our public services seem to have been run for the benefit of staff rather than those who use them" - I do wish people would stop making such accusations - not least because they are so wrong in so many ways.
For example how do I benefit from our A&E seeing >30% more patients than it did 10 years ago when there has been nothing like a 30% increase in staff?
Mind you - some nurses are being asked to work for nothing nowadays?
http://www.metro.co.uk/news/843243-nurses-are-told-to-work-shift-for-free
And it has been long known that the majority of nurses work far longer than their contracted hours (66% of them according to this report)
http://news.bbc.co.uk/1/hi/health/2395659.stm
NuLab had no concept of how much goodwill was involved during their disastrous reconfiguration of GP 'out of hours' services - and this good will is being eroded further as more members of the public buy into various Daily Mail type myths (including staff members running the NHS for their own good).
Comments like that are ignorant and offensive. Instead of routinely putting in unpaid hours every week, perhaps I should just live up to type and walk out of the hospital the minute the Trust stops paying me - in fact, the more I think about it the more the idea appeals?
I was going up to the North (now the other country called Scotland) on the train in the nationalised days. It was one of the most spectacular rides on any train and I have been on that one in Peru and Alaska.
Then it was privatised. Bother.
Hey! Now it is nationalised again.
Do they ever learn?
Neocon trolls out in force ,
The majority of the british public do not want the NHS privatised,
funny how none of these plans were in the conservative manifesto
Maybe we should have an election now to decide what the people really want !
sick patient who loves the NHS
Ever heard the expression 'Boring Old fart'?
Now we know where the pub bores go after closing time.
Well I think the NHS should not provide any services at all and they should all be provided by the private sector.
They did it for older peoples care and we all know how well the care homes industry is performing.
Perhaps it could be commissioned by the GP's who will ensure we get treatment free at the point of care.
That is of course if they are not too busy sitting about in meetings discussing what to do. Then of course they could employ managers to do that for them and just sit back and reap the rewards as they did in GP Fundholding days. Just look at the surgeries of the previous fundholders as compared to those who were not!
Y'know I'm in my 50s and I work in healthcare, I am worried sick not about what we are doing now (though there is cause) but about what will be available when I need it because if it declines as much in the next 15 years as it has in the last no amount of insurance will be enough.
Actually your apologies are due to Father Martin Niemoller not Dietrich Bonhoffer
http://www.history.ucsb.edu/faculty/marcuse/niem.htm
I can see what's happening to healthcare here. The local GP surgery is part of a pathway project for GP funding. They're moving their ground floor surgery to an upstairs one in a building to be built soon with a supermarket on the ground floor. The local community don't want the supermarket, and thousands of people have signed to say they don't want it, so the GPs have said they'll pull the funding for surgery facilities if the site is used for something other than a Tesco.
So the local people will get new surgery facilities but at the price of the new facilities being upstairs (better hope the lift doesn't break down and that none of the patients have claustrophobia) and at the price of having their village taken over by Tesco.
That's what's happening to the NHS. It's getting into bed with rapacious business.
Yes,I got it wrong. It was Martin Niemoller.
Schoolboy error.
Apologies
Yes,I got it wrong. It was Martin Niemoller.
Schoolboy error.
Apologies
The NHS has been getting into bed with rapacious business for the last 20 yrs because the Govts of the day (of whatever political stripe) have given it no choice...in the same way schools have to raise their own money for XYZ because the state funding has been cut. I doubt everyone on the commissioning boards was fooled by PFI, but some of the UN-fooled probably looked at it and said:
"If we do this, though it is a con, we get a new hospital building. If we DON'T do this, we are stuck with the old falling-down one as no way is the Govt giving us the money for a re-build."
- ditto contracted-out everything else.
As to David's remark about public services like the NHS being run "for the benefit of the staff"... Yore 'Avin' a Larf, Entcha?
I was thinking of telling Mrs Dr A this as she reappeared from work this evening, her 3.5 hr clinic (for which she is paid, after 15+ ys as a doctor, at a rate that equates to a less than banker-ish £ 50 K pa) having run to 5.5 hrs time worked. (Needless to say, she won't be paid for the last 2 hrs). This didn't happen because her clinic was running late, BTW - it was because she was the only doctor in the department, problems kept showing up that needed sorting before the weekend, and a combination of medical ethics and professional custom dictated that she stayed.
The railways have only "improved" if you live in a heavily urbanised area, along with all the other public services. Come live in the principalities of the north, and you will have a very different experience. Privatisation is the death knell for the Nhs and we all know it.
To quote Jarvis Cocker "fuck the morals, does it make any money?"
Post a Comment