We are all in this together, well not if you are in a union.

Andy_L

Procrastinator333 wrote: »

If that were true (I have no clue either way), and the NHS can do the op for £4k, someone should have organised it more efficiently so that the NHS can do the op for £4k rather than run out of capacity and have to pay BUPA £5k. Either way it is wasteful.

BUPA can do this particular operation cheaper because it can avoid a lot of the costs of providing a full hospital service,eg:
- If something goes wrong & the patient needs extended intensive care there'll be in an ambulance back to the NHS
- They don't train their medics - the NHS does it for them
-They can have a cheap out of town hospital as they don't have to be near their patients
-They don't have to have their surgical team avaliable 24/7 just in case somebody needs emergency treatment
- They don't have to cancel an operation because somebodys needs a life-saving operation after being knocked down by a bus

Procrastinator333

Andy_L wrote: »

BUPA can do this particular operation cheaper because it can avoid a lot of the costs of providing a full hospital service,eg:
- If something goes wrong & the patient needs extended intensive care there'll be in an ambulance back to the NHS
- They don't train their medics - the NHS does it for them
-They can have a cheap out of town hospital as they don't have to be near their patients
-They don't have to have their surgical team avaliable 24/7 just in case somebody needs emergency treatment
- They don't have to cancel an operation because somebodys needs a life-saving operation after being knocked down by a bus

I don't disagree that the NHS has all these additional costs, but they are not incremental costs associated with that individual operation. The fact is that the incremental costs of that operation must be a fair bit below the £5k. If not, BUPA couldn't make a profit and wouldn't do it.

If something goes wrong after the operation, it doesn't increase the cost of the operation itself.

Training of the medics occurs long before the operation and is not part of that £5k cost.

Why don't the NHS set up out of town locations for such procedures, there is certainly the scale there.

Having a surgical team on standby 24/7 is not a cost linked to the operation itself.

Cancelling one operation for another doesn't actually add much if anything in the way of costs.

BUPA can run a hospital building with required staffing, nurses, cleaners, admin etc, they can pay the doctors (who probably get paid more anyway), they can pay for all the equipment. They can run that set up and turn a profit on work the NHS throws their way. Why can't the NHS do the same?

carolt

Procrastinator333 wrote: »

Having a surgical team on standby 24/7 is not a cost linked to the operation itself.

How do you figure that out?

Of course it is. It ups the hourly rate.

I'm sure there is money to be saved in the NHS - cutting layers of bureaucracy seems an obvious one - but you need to pay for doctors/nurses to be available round the clock in case of emergency. That's not an area I'd like to see cuts in.

Procrastinator333

carolt wrote: »

How do you figure that out?

Of course it is. It ups the hourly rate.

I'm sure there is money to be saved in the NHS - cutting layers of bureaucracy seems an obvious one - but you need to pay for doctors/nurses to be available round the clock in case of emergency. That's not an area I'd like to see cuts in.

I'm not saying cut 24/7 care.

The cost of providing 24/7 care is a different cost to providing the surgeon for 5 hours to do a planned hip operation. They are in no way linked.

How does it up the hourly rate? Why would a doctor be paid more for perfoming a hip operation on a Monday, just because they are on call on the Tuesday. Sure they get paid more on the Tuesday because of the hours. But the actual cost of the op on the monday has nothing to do with that.

dopester

Thanks for you kind words before Carolt. Whilst we might not agree in the way forwards to solve many a problem, I do respect your honest position on many things which I often find are very centred around concepts of fairness.

carolt wrote: »

How do you figure that out?

Of course it is. It ups the hourly rate.

I'm sure there is money to be saved in the NHS - cutting layers of bureaucracy seems an obvious one - but you need to pay for doctors/nurses to be available round the clock in case of emergency. That's not an area I'd like to see cuts in.

Somehow this discussion has gone from teachers and unions to also covering the NHS.

Here is the lead story at the Daily Mail's site at the moment. Even Marklv can probably feel some frustration with this.

The pay of NHS bosses has soared by almost 7 per cent in a year - more than twice the rise for nurses.

There are now 25 health trust chief executives earning more than the Prime Minister's salary of £192,400.

The Opposition seized on the figures as further evidence that Labour cannot be trusted to keep public spending under control. They show that trusts rejected a request from ministers to limit senior managers' pay rises to 2.2 per cent.

http://www.dailymail.co.uk/news/article-1265267/Health-chiefs-pay-bonanza-As-nurses-salaries-squeezed-NHS-bureaucrats-pocket-7-rise.html

ninky_2

Procrastinator333 wrote: »

NHS is a great thing and if there was only a choice betwwen the US a bloated NHS as we have now, I would opt for the latter. However I don't believe they are the only options.

we all know the conservatives will spend less on the nhs (despite their protests to the contrary). the very fact they see the tripling of the nhs budget in real terms as a cause for derision (when the real derision should be the fact the tories saw fit to spend a third less than we are spending now) is evidence of that. i just don't fall for this 'bloated' argument. there are always improvements to be made but the nhs is continually improving under labour.

as for superbugs like mrsa. these are also a big problem in private healthcare and in the US where HAIs killed an around 48,000 - a far bigger percentage than die here in fact.

http://www.sott.net/articles/show/205495-Hospital-Superbugs-Kill-48-000-Patients-a-Year

Spartacus_Mills

ninky wrote: »

we all know the conservatives will spend less on the nhs (despite their protests to the contrary). the very fact they see the tripling of the nhs budget in real terms as a cause for derision (when the real derision should be the fact the tories saw fit to spend a third less than we are spending now) is evidence of that. i just don't fall for this 'bloated' argument. there are always improvements to be made but the nhs is continually improving under labour.

as for superbugs like mrsa. these are also a big problem in private healthcare and in the US where HAIs killed an around 48,000 - a far bigger percentage than die here in fact.

http://www.sott.net/articles/show/205495-Hospital-Superbugs-Kill-48-000-Patients-a-Year

First of all we do not know the Tories will cut NHS spending, you are just trotting out Labour party press releases. The Tories have made a commitment to health and would be foolish to break it and I doubt they will.

In real terms the Tories increased health spending all through the eighties and the nineties. The problem was, and still is, that the demand is increasing way in excess of real terms. That is the problem that has yet to be solved, like the pensions crisis, no matter how many gormless bunker soundbites are trotted.

That the NHS has got better under Labour is not in doubt, AFAIC, however I do believe it can improve and I do believe Labour have made mistakes. I am not sure we have got value for money with our tax pounds. Just throwing money at a problem without any thought is not a solution.

I also feel sending tactless mailshots to cancer sufferers misleading them about opposition policies is really low.

It all boils down to who you believe. As Gordon Brown is a proven Liar (lied to Chilcot and parliament about defence spending and lied to parliament about capital spending for starters) I will not take what he says on face value.

Andy_L

Procrastinator333 wrote: »

I don't disagree that the NHS has all these additional costs, but they are not incremental costs associated with that individual operation.

The cost of the operation has to carry all the on-costs of the organisation - its the way costing/accounting works.

Old_Slaphead

Andy_L wrote: »

The cost of the operation has to carry all the on-costs of the organisation - its the way costing/accounting works.

Not if it's marginal (sometimes called contribution) or replacement costing

Procrastinator333

Andy_L wrote: »

The cost of the operation has to carry all the on-costs of the organisation - its the way costing/accounting works.

That is not the correct way to asses how much you should be willing to pay to have someone else do it for you.

E.g take a receptionist. Say they get paid £14k by the nhs to work 9-5. Would you be happy if the nhs decided instead to pay £20k to an external firm to provide reception cover between 9-5?