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NHS clinical staff cuts


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#21 getdownmonkeyman

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Posted 01 January 2014 - 01:10 PM

As someone who has no inside knowledge of the NHS , I see the budget up by 2.6% for 13/14 . Are we saying that's not enough , is there too much waste or is there some other drag on the budget ? I suppose answering my own question as a big beast the NHS is , there is probably a thousand reasons why.

 

Tax breaks or greater funding for the NHS? We can't have both.


Edited by getdownmonkeyman, 01 January 2014 - 01:10 PM.


#22 getdownmonkeyman

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Posted 01 January 2014 - 01:20 PM

The Coalition Government has consistently stated, and the Tories before the election took place, that the NHS budget, like the schools budget, is ringfenced and no cuts were to be made to it for the duration of this parliament. 

 

I very much doubt that cuts in clinical staff have been the result of cuts to the NHS central budget.  A more likely scenario is that various NHS trusts being unable to fund their PPF payments.  Here in St Helens our only A&E unit is situated at Whiston Hospital which was substantially rebuilt under Labour and its PPF 'initiative'.  Approximately one third of the new build cannot be used because the trust cannot afford to run it thanks to PPF repayment costs. 

 

If the Trust cannot afford to run a third of the building, then it needs to have a bloody good look at itself. The repayment schedule will be known by all, upfront prior to signing the agreement and is contractually binding to all parties. 

 

PS

 

If you think the Lib Dems are not bending over and taking it for the fifteen minutes, go back to their 2010 manifesto section regarding tuition fees.



#23 shrek

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Posted 01 January 2014 - 01:31 PM

As someone who has no inside knowledge of the NHS , I see the budget up by 2.6% for 13/14 . Are we saying that's not enough , is there too much waste or is there some other drag on the budget ? I suppose answering my own question as a big beast the NHS is , there is probably a thousand reasons why.

I'm sure I've heard quoted an NHS inflation rate but can't find a link now, but from what I recall inflation does run higher in the NHS than in the general economy so I'd imagine there's a hit there despite budgets appearing to grow/be maintained. 

 

For me the bottom line is the NHS is such a beast that it must be almost unmanageable as a whole, I've had more contact with various NHS departments in 2013 than I'd like and as an outsider looking in at times cost savings look obvious, yet I dare say the moment you try and change things any cost savings are eradicated as the cost change/consultation/re-organisation kick in.

 

Pretty certain the answer isn't as simple as many above seem to imply by blaming on one party or the other, the problems in the NHS are deep rooted and it'll swallow as much cash as you throw at it I'm sure.



#24 getdownmonkeyman

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Posted 01 January 2014 - 01:51 PM

I'm sure I've heard quoted an NHS inflation rate but can't find a link now, but from what I recall inflation does run higher in the NHS than in the general economy so I'd imagine there's a hit there despite budgets appearing to grow/be maintained. 

 

For me the bottom line is the NHS is such a beast that it must be almost unmanageable as a whole, I've had more contact with various NHS departments in 2013 than I'd like and as an outsider looking in at times cost savings look obvious, yet I dare say the moment you try and change things any cost savings are eradicated as the cost change/consultation/re-organisation kick in.

 

Pretty certain the answer isn't as simple as many above seem to imply by blaming on one party or the other, the problems in the NHS are deep rooted and it'll swallow as much cash as you throw at it I'm sure.

 

Which is how the costs of PFI hospitals are driven up. Changes to schemes pre-financial close have to go through some many departments/sign-offs it is ridiculous. I can;t recall the specific figure, but I seem to recall the uplift (build cost only, excluding fees and funding) of a PFI hospitlal about 30% higher than non-PFI.

 

The greater issue is; how do we build hospitals without PFI? The country can't afford to do it via the Treasury, certainly not the extent required.



#25 KingKenny774

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Posted 01 January 2014 - 01:54 PM

The piece from the OP also mentions 7700 more clinical staff than 2010.

#26 ckn

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Posted 01 January 2014 - 01:58 PM

Which is how the costs of PFI hospitals are driven up. Changes to schemes pre-financial close have to go through some many departments/sign-offs it is ridiculous. I can;t recall the specific figure, but I seem to recall the uplift (build cost only, excluding fees and funding) of a PFI hospitlal about 30% higher than non-PFI.

 

The greater issue is; how do we build hospitals without PFI? The country can't afford to do it via the Treasury, certainly not the extent required.

Of course it can.  The UK government has a £100bn infrastructure budget planned out from 2015 to 2020, that's £20bn a year.  A typical big hospital costs about £500m to build from scratch but then comes with the long-term benefit of being completely mortgage/PFI free meaning no millstone around the hospital's budget for 30 odd years.

 

As I've said in plenty of other threads, we're planning to spend £40bn on HS2, that's about 100 brand new hospital builds.


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#27 shrek

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Posted 01 January 2014 - 02:32 PM

As I've said in plenty of other threads, we're planning to spend £40bn on HS2, that's about 100 brand new hospital builds.

Which to me would seem a much better use of money, plus the spread around the country would give significant and wide ranging boosts to local economies as there being built.  Along with avoiding the battle with the Tories of middle England who don't want HS2 running through there back garden and they'd take the wind out of the "can't trust tories with the NHS" argument. 

 

The fact there not building hospitals and are trying to build HS2 does make me think I'm missing the obvious!



#28 Trojan

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Posted 01 January 2014 - 04:36 PM

Which to me would seem a much better use of money, plus the spread around the country would give significant and wide ranging boosts to local economies as there being built.  Along with avoiding the battle with the Tories of middle England who don't want HS2 running through there back garden and they'd take the wind out of the "can't trust tories with the NHS" argument. 

 

The fact there not building hospitals and are trying to build HS2 does make me think I'm missing the obvious!

It'll never happen.  The only interest the Tories have in the NHS is to neutralise it as an election issue, and should they win next time continue dismantling it. Mark my words that's what they want. Many of them have said as much. And once it's gone no government will be able to afford to bring it back in its intended from.  You really can't trust the Tories with the NHS.


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#29 getdownmonkeyman

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Posted 01 January 2014 - 04:57 PM

Of course it can.  The UK government has a £100bn infrastructure budget planned out from 2015 to 2020, that's £20bn a year.  A typical big hospital costs about £500m to build from scratch but then comes with the long-term benefit of being completely mortgage/PFI free meaning no millstone around the hospital's budget for 30 odd years.

 

As I've said in plenty of other threads, we're planning to spend £40bn on HS2, that's about 100 brand new hospital builds.

 

Of that £20 billion, how much is for essential maintenance/must have roads and motorways? Plus, being realistic, it is a cracking headline grabber, but let us see how much of that £100bn is actually realised. Furthermore, if the capital is available why is it not being spent on hospitals (and housing for that matter)?

 

HS2 reeks of a White Elephant to me, even if it should happen, I wouldn't be surprised to see it being privately funded.

 

Don't get me wrong, an economy the size of the UK should not require private funding for basic requirements, but as it stands, for some reason, it does.



#30 Saintslass

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Posted 01 January 2014 - 07:17 PM

Of course it can.  The UK government has a £100bn infrastructure budget planned out from 2015 to 2020, that's £20bn a year.  A typical big hospital costs about £500m to build from scratch but then comes with the long-term benefit of being completely mortgage/PFI free meaning no millstone around the hospital's budget for 30 odd years.

 

As I've said in plenty of other threads, we're planning to spend £40bn on HS2, that's about 100 brand new hospital builds.

I'm not a fan of HS2.  In fact, I think it's a destructive waste of money.  However, the argument you are using was used by some before the Olympics and indeed could be used about anything at any time.  The NHS swallows money in great big gulps and has the appetite to digest as much of it as is thrown at it.  That doesn't mean we should be depriving ourselves of other things in order to feed it. 



#31 Saintslass

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Posted 01 January 2014 - 07:20 PM

It'll never happen.  The only interest the Tories have in the NHS is to neutralise it as an election issue, and should they win next time continue dismantling it. Mark my words that's what they want. Many of them have said as much. And once it's gone no government will be able to afford to bring it back in its intended from.  You really can't trust the Tories with the NHS.

This mantra is getting old.  The NHS changed under Labour - they brought in PFI whereas the previous Tory government refused to do so.  Yet I don't see you suggesting Labour wanted to dismantle the NHS.

 

The NHS needs wholesale reform irrespective of some outmoded leftwing dogma. 



#32 shrek

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Posted 01 January 2014 - 07:56 PM

It'll never happen.  The only interest the Tories have in the NHS is to neutralise it as an election issue, and should they win next time continue dismantling it. Mark my words that's what they want. Many of them have said as much. And once it's gone no government will be able to afford to bring it back in its intended from.  You really can't trust the Tories with the NHS.

This is where we'll disagree, you continue to make it a party political point and I don't see how when none of the three parties can be trusted with the NHS in my opinion.

 

You seem to gloss over the last Labour government loading up the NHS with PFI debt whilst starting the ball rolling on follies such as HS2.  So what will happen if Labour return to power in 2015 is it all going to be rosy in the NHS garden or is it set to be saddled with more debt it can ill afford?


Edited by shrek, 01 January 2014 - 07:56 PM.


#33 Padge

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Posted 02 January 2014 - 12:39 AM

There will be a sever shortage of nurses soon as budget cuts mean that the funding for student nurses is getting cut left, right and centre and retiring nurses will not have replacements coming through the system.

 

Also once a nurse is qualified opportunities for development are being cut, so you finish up with fewer less trained nurses looking after your beloved when the time comes that you really need the absolutely brilliant NHS.

 

Of course those with a few bob can help the private health care system by buying expensive insurance to cover their costs using NHS employees to sort them out privately.

 

Time to make the medical profession to make a decision, either all private or all NHS, if if you are all private then the NHS dictates the price you are hired for. That price will always be half of what an NHS employee is paid.

 

Long lists I here JohnM cry, no, a reality on worth to the whole society will be the wake up call.

 

Actually I would ban all private medicine.



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#34 Trojan

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Posted 02 January 2014 - 08:44 PM

 

The NHS needs wholesale reform irrespective of some outmoded leftwing dogma. 

http://www.theguardi...health-serviceshttp://www.telegraph...-the-world.html


Edited by Trojan, 02 January 2014 - 08:48 PM.

"This is a very wealthy country, money is no object" D. Cameron February 2014


#35 Saintslass

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Posted 02 January 2014 - 09:54 PM

There will be a sever shortage of nurses soon as budget cuts mean that the funding for student nurses is getting cut left, right and centre and retiring nurses will not have replacements coming through the system.

 

Not according to Health Education England, which is increasing its nurse training provision by 9% this year (as referred to in this blog: http://www.bbc.co.uk...health-25428847 )

 

 

Also once a nurse is qualified opportunities for development are being cut, so you finish up with fewer less trained nurses looking after your beloved when the time comes that you really need the absolutely brilliant NHS.

Where is the evidence to back up this claim?  Given that the government is increasing the nurse training provision the opposite would appear more likely to be the case.

 

A high number of employees does not equate to a good service.  The reviews and discussions about the NHS that have taken place over the last 12 months have focused on the quality and appropriateness of provision, not its breadth.  Nurses who show no compassion should be fired as they are there to care for patients not neglect them.  LIkewise, hospitals which cannot organise their shift systems to provide adequate staffing levels over a weekend, something that has been the case ever since I've been alive anyway (and I'm in my 40s), should be challenged and made to change.

 

Changes to the NHS have to be both systemic and cultural as both have been problematic for decades but no government has had the political will/nerve to face the problems head on.  Thus, the crises that have been exposed over the last year or so in various Trusts provide an ideal opportunity to tackle these matters and that will require possibly quite significant changes to the NHS, in hospitals and outlying services.

 

 

Time to make the medical profession to make a decision, either all private or all NHS, if if you are all private then the NHS dictates the price you are hired for. That price will always be half of what an NHS employee is paid.

There have been private elements to the NHS for years: prescriptions, dental treatment, abortions past a certain time limit (used to be 12 weeks), etc.  Once upon a time, NHS hospitals used to benefit from having a number of private patients within their walls but I think a Labour government abolished this practice.  Nowadays hospitals make some money via car parking charges instead.  I think I prefer the private hospital beds!  There will never be enough public money to fund the NHS because it is simply too expensive.  So we have to make the NHS as efficient as possible in order to continue to afford it. 


Edited by Saintslass, 02 January 2014 - 09:54 PM.


#36 Saintslass

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Posted 02 January 2014 - 09:57 PM

What was your point?



#37 Padge

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Posted 03 January 2014 - 10:49 AM

Not according to Health Education England, which is increasing its nurse training provision by 9% this year (as referred to in this blog: http://www.bbc.co.uk...health-25428847 )

 

 

 

My wife is a senior university lecturer in Nursing so is right in the front line of nurse training, so I think she knows the absolute reality of the situation.



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#38 Saintslass

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Posted 03 January 2014 - 03:37 PM


If you think the Lib Dems are not bending over and taking it for the fifteen minutes, go back to their 2010 manifesto section regarding tuition fees.

The Tories have also had to sacrifice some of their policies.  That is the price you pay when in coalition.

 

I remember prior to the last election there being a lot of chatter in the media and on forums about how great proportional representation would be.  I wonder what such people's opinion of that electoral approach is now because with PR we would get endless coalitions in which nobody could really promise anything as compromises always have to be made when in coalition.



#39 Saintslass

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Posted 03 January 2014 - 03:38 PM

My wife is a senior university lecturer in Nursing so is right in the front line of nurse training, so I think she knows the absolute reality of the situation.

If that is the case then she will already know that the government is planning a 9% increase in nurse training places.



#40 Padge

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Posted 03 January 2014 - 04:24 PM

If that is the case then she will already know that the government is planning a 9% increase in nurse training places.

 The government can say what they want, there is a shortage of clinical work areas willing to offer placements to students due to their budgets being cut by your shyster mates in Downing Street.


Edited by Padge, 03 January 2014 - 04:25 PM.


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