tag:blogger.com,1999:blog-25200961.post5865530802432903537..comments2024-03-14T09:50:40.819+00:00Comments on Dr Grumble: David Cameron on the NHSDr Grumblehttp://www.blogger.com/profile/04417731064007601504noreply@blogger.comBlogger51125tag:blogger.com,1999:blog-25200961.post-725255705146261042010-01-25T20:40:35.785+00:002010-01-25T20:40:35.785+00:00The ultimate failure of the NHS IT system was the ...The ultimate failure of the NHS IT system was the culmination of many years of NHS management bungling. Read more about how taxpayers' money is being squandered <br /><br />here:http://www.taxpayersalliance.com/waste/2009/09/nhs-emergency-surgery.html<br /><br />Incidentally, the writer of this article is an old mate of your fellow blogger Dr Crippen.davidnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-11843021086558871372010-01-25T08:07:39.003+00:002010-01-25T08:07:39.003+00:00What's your point, David? It was private compa...What's your point, David? It was private companies that failed to deliver on the NHS IT programme.Dr Grumblehttps://www.blogger.com/profile/02459592334604944530noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-46797511922627116712010-01-25T00:33:43.175+00:002010-01-25T00:33:43.175+00:00"But many of us do not believe that such a sy..."But many of us do not believe that such a system can possibly be efficient."<br /><br />Really! In my opinion, Government-run organistions are the most inefficiently run in the country. Millions are wasted every day. What about the aborted NHS IT system, for example?davidnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-63650331339062110922010-01-23T23:58:50.383+00:002010-01-23T23:58:50.383+00:00"in France you have 3 doctors doing work whic..."in France you have 3 doctors doing work which in the UK would be done by just 2 doctors."<br /><br />Soon we'll have one doctor doing the work of those 3 in France - if we're lucky! The nurses will do the rest!Rajnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-65711409147361063892010-01-23T21:07:39.619+00:002010-01-23T21:07:39.619+00:00You may be right, David, that there would be some ...You may be right, David, that there would be some personal advantages to doctors to have an insurance system. But many of us do not believe that such a system can possibly be efficient. <br /><br />We are told that systems like the French one are very much better than ours but the French system is struggling and you cannot compare the quality of care in France with that in the UK given that until recently the NHS was grossly underfunded.<br /><br />In 2003 the UK had 2.2 doctors per 1000 people whereas France had 3.37 (2004 figures). So in France you have 3 doctors doing work which in the UK would be done by just 2 doctors. It says very little about the systems and more about the funding at the time.<br /><br />Insurance systems waste money moving the money about. Unfortunately that is now happening in the NHS and accounts for the increase in managers who are needed to commission services and sort out the billing. That, many of us would contend, is never going to be an efficient way of doing things though we are now stuck with it since the policies of the main parties do not differ on this.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-15101184693119578452010-01-23T20:45:30.496+00:002010-01-23T20:45:30.496+00:00To get back to the original comment, Britain has m...To get back to the original comment, Britain has much to learn from our European neighbours who seem to run much more efficient health sevices than the poor old NHS. This hasn't been ignored by centre-right pressure groups who advocate a state-backed social insurance model. I cannot understand why so many doctors are opposed to such a system whoch would give them more professional independence than a micromanaged state-run nationalised monolith.davidnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-84603645909556848182010-01-22T16:37:11.556+00:002010-01-22T16:37:11.556+00:00A friend of Dr Grumble's did this one.A friend of Dr Grumble's did <a href="http://4.bp.blogspot.com/_b5GSryT89p0/S1YZVwYgfSI/AAAAAAAABu8/07crMjcG9E4/s1600-h/poster.jpg" rel="nofollow">this one</a>.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-81319766025800628722010-01-22T16:30:06.306+00:002010-01-22T16:30:06.306+00:00Talking of that nice Mr Cameroon, anyone wanting t...Talking of that nice Mr Cameroon, anyone wanting to "vent" a little at the prospect of his running the country can now <a href="http://www.andybarefoot.com/politics/cameron.php" rel="nofollow">produce their own Cameron poster.</a><br /><br />There are some examples <a href="http://mydavidcameron.com/" rel="nofollow">here,</a> including one with a medical subtext right at the top.Dr Austhttp://draust.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-64555161716939358212010-01-14T11:45:23.982+00:002010-01-14T11:45:23.982+00:00Anonymous said...
This is precisely why Cameron ne...<i>Anonymous said...<br />This is precisely why Cameron needs to consider radical reform. Under NuLabour most of the extra spending on the NHS was spent on pay rises!<br />;)</i><br /><br />Pasty-faced 'Let's privatise everything' Cameron would have no role in my vision of a continental-style healthcare utopia!Anonymous2noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-16946128425109587622010-01-13T17:27:43.942+00:002010-01-13T17:27:43.942+00:00"This is precisely why Cameron needs to consi..."This is precisely why Cameron needs to consider radical reform. Under NuLabour most of the extra spending on the NHS was spent on pay rises!"<br /><br />Wot! More reform! And any reform will never be as compresensive, accurate and thourough as Darzi's - because he took to the road for a whole year and listened before he decided - and he is a top doctor, top academic too! It works best if the reform is done by the best! The conservatives can not match that if they stood on their heads!<br /><br />That's why Cameron must never be allowed into that office!<br /><br />Watch that video where a wise nurse was just talking about this non ending reform, she said (Second half of video) that staff needs 'a period of consolidation' - How right she was too!<br /><br />http://www.youtube.com/watch?v=TTJew601aM0Anonymousenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-70066421071433129652010-01-13T16:53:13.143+00:002010-01-13T16:53:13.143+00:00"Under NuLabour most of the extra spending on..."Under NuLabour most of the extra spending on the NHS was spent on pay rises!"<br /><br />So does 'radical reform' essentially translate into pay cuts for nurses (amongst others).<br /><br />By the way will 'radical reform' include paying NHS staff for the millions of unpaid hours they put in?the a&e charge nursenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-32413189006910114562010-01-13T16:38:54.540+00:002010-01-13T16:38:54.540+00:00"I'd be happy to pay higher levels of nat..."I'd be happy to pay higher levels of national insurance for a continental-style healthcare system. But I'd like to think my tax money was going on treatments, equipment, provision of more nurses etc. than on paying for some GP partner's third BMW."<br /><br />*******<br /><br />This is precisely why Cameron needs to consider radical reform. Under NuLabour most of the extra spending on the NHS was spent on pay rises!<br />;)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-48758332645921291742010-01-13T14:35:56.331+00:002010-01-13T14:35:56.331+00:00"Some people are motivated to work hard becau..."Some people are motivated to work hard because they take pride in their work."<br /><br />Now you're talking! That's what you would guarantee from 'comfortable, motivated and well rewarded people'<br /><br />Let's keep your wisdom in perspective then :-)Samhttps://www.blogger.com/profile/09558370387772079822noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-5695990566735053152010-01-13T14:27:39.019+00:002010-01-13T14:27:39.019+00:00"Sam, I think that in a system where resource..."Sam, I think that in a system where resources are limited, GP partners should take some responsibility for curbing the amount they profit from the system. It's all very well for doctors to complain about an under-resourced system but surely it is worth analysing where the money is being spent?<br /><br />I'd be happy to pay higher levels of national insurance for a continental-style healthcare system. But I'd like to think my tax money was going on treatments, equipment, provision of more nurses etc. than on paying for some GP partner's third BMW.<br /><br />If other European nations can provide greater amounts of higher quality healthcare, delivered by more doctors at cheaper wage levels, then why can't the UK?"<br /><br />You are under the impression that I am differing with you when I am not. It is my modus operandi too (I love this expression! :-) that when I contract someone to do something for me, that I 'try my best' to get value for my hard earned money too - so we are in agreement about that. The 'only' difference we have is that I don't believe that making money is a sin! Or indeed, that poverty is a sin either! If those GPs provide quality work that is also good value for money, I don't care how many BMWs they have parked in front of their manor house. Different if they don't, so, we're in agreement!<br /><br />However, what I also was trying to say is that once 'you' contract someone, say, to change at tap in your house, you can't come back and ask them to drop the price simply because you now find you could have had it done cheaper else where!<br /><br />If 'some' GPs are 'milking the system' then you need to exert control 'on the system' so that you can get your value for money.<br /><br />So, see, we're in agreement but I think private sector, you think public sector ... I am sure the best way is to adapt the best methodology from both; ie, I will pay well but I want my money's worth! ... so, those who don't, go after them, ask for your money's worth ... or else!Samhttps://www.blogger.com/profile/09558370387772079822noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-51908704204837188062010-01-13T14:09:11.812+00:002010-01-13T14:09:11.812+00:00"that explains your personal motivation for b..."that explains your personal motivation for believing that they have it worse than everyone else and that they should be paid large sums etc."<br /><br />When did I ever speak of large sums?! ... and I NEVER speak about my children alone but about young medics in general! People should be paid their worth, in whatever field! A graduate medic deserves more than the current pathetic £21k, Surely!<br /><br />"I know graduates who are far more educated than the average doctor (ie. with Phds), who are working for free. The more competitive the industry you enter, the more likely you are to spend a stint working for free."<br /><br />I am aware of that but it depends what PhD you have and if it is worth the paper it is written on because with 'real' PhDs you normally have no problem. That said, two wrongs don't make a right, so, those need to fight for their rights too. <br /><br />And by the time the medics graduate, they would have already worked for three whole years for free too; uni being three years longer. And they do give the extra free hours, lots, once they graduate and start work too. Because a medic can not exactly say' it's 5pm, I'm off' when they are in theatre for example, can they? Actually, I know one young doctor whose hospital insists on NOT working more than the 48 hours now imposed by the EWTD, ie, 9 to 5pm and that's it, no more allowed. But then the ward rounds are at 7- 7.30am and theatre is on till 6pm, then you need to check on patients ... so in effect, they work 12 hours minimum a day without any overtime allowence! ... and the hospital just says, you can go home if you wish ... but, can they? Generous, don't you think? At least give them a decent minimum pay to be able to live with dignity! <br /><br />I also know a couple of medics, both f1s who can't get married because they won't be able to support a home financially so, they won't .. yet!<br /><br />"You seem to operate under the illusion that medicine is the most competitive of careers. Perhaps at the point of university entry (ie. Alevels) it is."<br /><br />No, I don't. Medicine is a calling and that's how people get into it - because of the job itself.<br /><br />"However there are many post-university careers that operate more extreme competitive entry procedures. I have medic friends who have tried - and failed to enter such fields."<br /><br />Luck of the draw! So, one would get in and one would not despite both being of equal calibre. And since the field your friend was trying to get into is extreme re competition, it doesn't mean he was below standard though, right? ... Because it's always like that in those cases since employers/unis have to stick to certain quotas ... medical schools are famed for this nowadays as it seems they are turning the taps down a bit post MTAS<br /><br />:-)Samhttps://www.blogger.com/profile/09558370387772079822noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-52211770583263612312010-01-13T14:05:21.385+00:002010-01-13T14:05:21.385+00:00So, it is not the GPs you need to blame because th...<i>So, it is not the GPs you need to blame because they simply negotiated a contract that takes care of their intrests,or as you put it 'profits'- much like any other profession in the public sector does when it negotiates a contract with government.</i><br /><br />Sam, I think that in a system where resources are limited, GP partners should take some responsibility for curbing the amount they profit from the system. It's all very well for doctors to complain about an under-resourced system but surely it is worth analysing where the money is being spent?<br /><br />I'd be happy to pay higher levels of national insurance for a continental-style healthcare system. But I'd like to think my tax money was going on treatments, equipment, provision of more nurses etc. than on paying for some GP partner's third BMW.<br /><br />If other European nations can provide greater amounts of higher quality healthcare, delivered by more doctors at cheaper wage levels, then why can't the UK?<br /><br />Some people are motivated to work hard because they take pride in their work. Others are motivated to work hard because they feel committed to a particular cause. Not everybody's modus operandi in life is to own the biggest house or the fastest car. <br /><br />Perhaps, European medical schools attract applicants who are less money-driven and more socially responsible.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-14595018035969220322010-01-13T13:36:10.496+00:002010-01-13T13:36:10.496+00:00Sam, I didn't realise your children were medi...Sam, I didn't realise your children were medics, that explains your personal motivation for believing that they have it worse than everyone else and that they should be paid large sums etc.<br /><br />I know graduates who are far more educated than the average doctor (ie. with Phds), who are working for free. The more competitive the industry you enter, the more likely you are to spend a stint working for free.<br /><br />You seem to operate under the illusion that medicine is <b>the</b> most competitive of careers. Perhaps at the point of university entry (ie. Alevels) it is. <br /><br />However there are many post-university careers that operate more extreme competitive entry procedures. I have medic friends who have tried - and failed to enter such fields.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-14717627206155709092010-01-13T08:48:29.986+00:002010-01-13T08:48:29.986+00:00And if you choose to refer to the public sector
=...And if you choose to refer to the public sector<br /><br />===<br /><br />Meant to say 'private' sector<br /><br />:-)Samnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-80597896141283651332010-01-13T08:46:37.393+00:002010-01-13T08:46:37.393+00:00"and you hardly find graduates working for fr..."and you hardly find graduates working for free three years after graduation".<br /><br />That's simply not true, Sam - according to this item;<br />"Annual employment figures show NURSES work an average of more than four hours unpaid every week, and more than seven if they do overtime".<br />http://news.bbc.co.uk/1/hi/wales/7411785.stm<br /><br />So, the NHS benefits from virtually a full days work, gratis from the overtime cohort of nurses - I'm sure the same goodwill would not exist if your boss was a sinister beardy like Richard (don't pay the cabin crews) Branson.<br /><br />Do the maths - there are 400,000 nurses in the NHS, most are expected to work additional, unpaid hours irrespective of their grade (year in year out).<br /><br />The marketeers never seem factor the cash benefits (for patients) associated with staff commitment to the NHS ethos. <br /><br />It goes without saying that the gargantuan volume of work carried out for free by yesteryears junior doctors kept the NHS rumbling along - now some of this work has been devolved to the quacks, and while the quacks might be loathed (by some) at least they put in their fair share of unpaid work as well.the a&e charge nursenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-32062452113463498042010-01-13T08:44:14.453+00:002010-01-13T08:44:14.453+00:00"something which Cameron has promised to '..."something which Cameron has promised to 'rectify' if the Conservatives are elected."<br /><br />Rectify?! You see, this is the problem with modern British politics, this incredible raid on people's livelihoods while at the same time wasting billions on failed initiatives like the swine flu 'panacademic'! How many docs and nurses could you pay with 'half' of this wasted money?! And, why should those on the frontline have a pay freeze when there is all this money around but is being squandered?! I wonder if that money was used to better wages, would it translate into 10+% increase for a strapped for cash junior or graduate nurse? What percentage would you estimate?<br /><br />That's why people are disillusioned with all parties because they are told one thing and see another! Again, I think any party would be stupid to attempt to 'rectify' public sector pensions when people are in that state of doubt. I suppose it is best for a clever politician to put his own house in order first - 'if' they get elected - and that applies to anyone. And if you choose to refer to the public sector, please compare like for like 'in this country'- how much does a successful Harley Street consultant make per annum on top of their NHS wage?! Who needs a subsidised pension then? Only the current system does not allow for enterpeneurialship but for the very lucky few ... and I can't see that changing soon because that will mean the end of the NHS as we know it.<br /><br />So, you have to choose, either to subsidise or prepare for and allow enterpenurialship - because people can not survive on water alone.Samnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-18068050664237689032010-01-13T00:37:20.475+00:002010-01-13T00:37:20.475+00:00"And about the seniors, you might argue that ..."And about the seniors, you might argue that European doctors are paid less for more quality and productivity ... but, we are not in Europe ... and we have a different system and a different set of values ... and when in Rome ...!"<br /><br />It could of course be argued that doctors in the rest of Europe are paid the market rate because they operate within the private sector; and don't forget that NHS employees pay nothing like the true cost of their pension benefits, something which Cameron has promised to rectify if the Conservatives are elected.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-77073989939677172762010-01-12T23:07:27.003+00:002010-01-12T23:07:27.003+00:00Trainer 1 thinks Dr Grumble is right. The NHS is b...Trainer 1 thinks Dr Grumble is right. The NHS is being privatised deliberately. It would be a defianace of logic to think otherwise. <br /><br />NHS privatisation is what we have all come to recognise as an 'agenda'. As a general rule when one is confronted with an 'agenda' one must ask the following.<br /><br />If the agenda is politically unpopular (at times politically suicidal) what is motivating the politicians to drive it?<br /><br />Have politicians or policy makers suddenly recanted previous beliefs and become converts to the agenda? If so why?<br /><br />Does the agenda continue regardless of changes in political (or other) leadership?<br /><br />Are'charities', think tanks, IGOs and NGOs or other'change agents' (who sit outside democracy) involved. If so who is funding them, and why?<br /><br />If the agenda flies in the face of evidence, seems to conflict with the stated aim and generally defies common sense, is it possible that there is another aim which has not been stated?<br /><br />Cicero, in Roman times, applied simple logic and asked "Cui bono?". In these baffling times of mind-boggling bail-outs, inexplicable wars and dubious viral threats to 'all humanity' we must not forsake our logic. Denial and doublethink is no refuge. <br /><br />Trainer 1 thought the third way was to be a gentle free market and a socialist 'safety net'. Few realised this actually meant widescale corporate capture with a soviet 'big-state' deployed to advance coporate interests.<br /><br />To see this in action, on a 'global' scale, one only needs to look at this. <br /><br />http://paulflynnmp.typepad.com/Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-10951082829340752652010-01-12T21:04:05.778+00:002010-01-12T21:04:05.778+00:00"European GPs still do more home visits and h..."European GPs still do more home visits and handle their own out-of-hours for less money than their UK colleagues.UK GPs took a massive pay rise at the same time as ditching their responsibility for our-of-hours.<br /><br />Paying doctors more certainly does promote ownership... that is to say ownership of profits!"<br /><br />Then ask them to take out of hours back - but don't penalise them because some not very clever person in government agreed a contract with them that was, in the eyes of government afterwards, stupid! It takes two hands to clap after all! IMO, this is the consequence of not having someone 'in the know' in government! I bet had there been a doctor in power then, this contract would have looked very different! So, it is not the GPs you need to blame because they simply negotiated a contract that takes care of their intrests,or as you put it 'profits'- much like any other profession in the public sector does when it negotiates a contract with government. And we all live on our 'profits', don't we?<br /><br />"Sam, in many competitive industries you will find graduates working quite literally for free for long periods of time to get the necessary experience they need to get ahead.<br /><br />Some grads I know work for free and their lifestyles have to be funded by their parents."<br /><br />Sure, we all know 'some' of those graduates. In this current economic climate, those you mention are even the lucky ones, considering only 30% of class 2009 were able to find anything at all! Sad!<br /><br />But there are two points to consider with young docs, first, they spend double the time at uni .. and you hardly find graduates working for free three years after graduation. Second, of course you know how tough a life it is to prepare a child for medical school, right from birth literally. Not only ensuring they are to grow to be the best of their class all along only but to have extra interests and activities to prove they are not book worms but can manage their time well, multi-task and be coutious and sociable, compassionate .. etc too! Surely those of that same 'pick of the crop' others who graduate other diciplines do not work for free, do they? The ones I know don't anyway, one much less in ability than my children, is making double the money 2 years after graduation - my child was still preparing for their tough finals still! And I do supplement their income you know, honest! specially during the foundation years. It can't be right, eh? :-D<br /><br />Unless you reward people properly and in corrolation with what they offer you, the notion of demanding excellence and dedication from them becomes a mirage!<br /><br />There is all this talk now about learning from other industries how to improve safety ... etc, why not also learn how to improve front line staff contentment, as happens in the private sector - then demand and insist on quality from them ... (please read about 'Google's staff, for example) ... and save the money you want to save! - and btw, this is the safest and most proven way to cutting costs and reducing waste - investing in talent :-)<br /><br />As for bankers and footballers, why didn't anyone tell me! I would've learned to play the stuff mysel and been wealthy enough to spare my children the agony of preparing and studying medicine!<br /><br />Don't believe that! I HATE football! - grown up men fighting over a rounded piece of skin - indeed! - give them a ball each and let us live in piece! :-DSamnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-55050027417690789272010-01-12T14:15:33.122+00:002010-01-12T14:15:33.122+00:00Sam said...
Incidently, what do you think of ...<i>Sam said...<br /><br /> Incidently, what do you think of the juniors pay and the extra hours they do for free Anonymous? Is it fair?</i><br /><br /><br />Sam, in many competitive industries you will find graduates working quite literally for free for long periods of time to get the necessary experience they need to get ahead.<br /><br />Some grads I know work for free and their lifestyles have to be funded by their parents. Others work 16 hours a day, 8 hours in an unpaid internship and 8 hours behind a bar on the minimum wage - they live (with much difficulty) on half the minimum wage. <br /><br />These graduates who work for free don't benefit from an NHS pension or other perks of working for the public sector.<br /><br />Certainly, junior doctors may feel aggrieved when they look at the salaries of bankers or footballers. Most people feel that way.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-23045955727484190372010-01-12T13:59:02.832+00:002010-01-12T13:59:02.832+00:00Sam said...
And about the seniors, you might argu...<i>Sam said...<br /> And about the seniors, you might argue that European doctors are paid less for more quality and productivity ... but, we are not in Europe ... and we have a different <br /><br />system and a different set of values ... and when in Rome ...!<br /><br /> We don't want our doctors to be underpaid ... much better to pay them well, promote ownership in order to reduce waste and improve on performance and productivity, then hold them to account if they fail to do that.</i><br /><br />European GPs still do more home visits and handle their own out-of-hours for less money than their UK colleagues.<br /><br />UK GPs took a massive pay rise at the same time as ditching their responsibility for our-of-hours.<br /><br />Paying doctors more certainly does promote ownership... that is to say <b>ownership of profits!</b><br /><br />The UK medical profession runs a closed-shop, training few doctors (compared to EU countries) and paying inflated wages.<br /><br />Everyone mentions Germany but there are lots of countries in Europe who we could learn something from...<br /><br />Netherlands, Denmark, Iceland, Austria, Switzerland, France, Sweden, Luxembourg, Norway, Belgium etc.<br /><br />Why we always have to model ourselves on the US is beyond me.Anonymousnoreply@blogger.com