the snap general election thread

kabayiri

- Obesity is on the rise, and just the diabetes issue alone is set to cost billions in the years to come.

- Certain cancers like Asbestos cancer are not due to peak until 2020, and are extremely expensive to treat.

- Health problems from diesel emissions will become a big issue, particularly in the increasingly congested cities.

Remind me again why I can be confident that a single mayor can "fix the NHS"?

A_Medium_Size_Jock

kabayiri wrote: »

Every single capital project, either in the NHS or outside it, should have measurable targets.

Otherwise, how do you learn the lessons and not continue to repeat the mistakes in to the future?

An example. We should all be familiar with the NHS IT project which ran for about a decade from 2003 to 2013.

There's over £12 billion pound of spend right there.

Did the project achieve it's goals then?

Well, even as early as 2007 the government attracted criticism for their "apparent reluctance to audit and evaluate the programme"".

It seems not.

It's not like this hadn't happened before. In the early 90s the several billion pound OR project resulted in dismally low delivery.

...and you wonder why I have low trust in governments to deliver value for money!

Ah yes.
Like the "Universal Credit" farce.
Which I will not dwell upon, it angers me so.
The estimated cost to implement so far: £15.8 billion! :eek:

BobQ

kabayiri wrote: »

- Obesity is on the rise, and just the diabetes issue alone is set to cost billions in the years to come.

- Certain cancers like Asbestos cancer are not due to peak until 2020, and are extremely expensive to treat.

- Health problems from diesel emissions will become a big issue, particularly in the increasingly congested cities.

Remind me again why I can be confident that a single mayor can "fix the NHS"?

He never said he could.

Nothing will ever be attempted if all possible objections must first be overcome. Samuel Johnson
Read more at: https://www.brainyquote.com/quotes/quotes/s/samueljohn122057.html

antrobus

Thrugelmir wrote: »

How many products and external services does the NHS use? ...

God knows. Tens of thousands at least. Probably more.

I know a bit about it because I briefly worked for a NHS trust back in the 90s getting their purchasing system to work. They bought a lot of Bic Cristal pens. And shedloads of other stuff.

kabayiri

antrobus wrote: »

God knows. Tens of thousands at least. Probably more.

I know a bit about it because I briefly worked for a NHS trust back in the 90s getting their purchasing system to work. They bought a lot of Bic Cristal pens. And shedloads of other stuff.

Pens are great value, but in the hands of young children they are a potential A&E case

There's a local IT company who provide an eProcurement gateway, and count the NHS amongst their customer base.

It's a growing sector, so there is potential for a lot of savings. You don't need to build everything inhouse.

CKhalvashi

Thrugelmir wrote: »

Under Brown the welfare state became somewhat bloated in term of complexity and administration. The public sector is as far from efficient as you can get in many areas. Taxpayers money needs to spent well. Worth following the National Audit Office reports that get published. Plenty of criticism of many initiatives. Politicians generally may have the ideas but lacking as to how to implement effectively at ground level.

A theoretical CK government would have cash benefits somewhere between where they were and where they are now, with minimum wage to increase at CPI + 1% annually for the duration of the parliament.

The same theoretical CK government would focus on increasing tax through extending business financing schemes (through the use of paid guarantees, thus meaning no money needing to be spent up front), with priority guarantees to be given over the company assets for the course of the term the guarantees are given, i.e there should be a net increase in revenues with no cost to the taxpayer.

There would be a focus on increasing public sector efficiency partly through centralisation of purchasing, and giving the ability to buy small items to individual staff, to be refunded in cash from a small-ish pot on site. There's no point having a purchasing contract on a pack of 10 Bic pens at what's probably an overinflated price when Tesco etc do the job just as well; in fact I've lost count of the number of pens etc I've bought for work use, but never bothered to claim.

There would be a bonded training system for all government staff, to be set at (as an example) 15% of wages per year, to ensure that training isn't paid for just before someone leaves (as in there is a full right to leave, but the training costs will need to be paid as an interest bearing loan if not cash), with a preference for staff to be redeployed between government departments unless completely impractical to do so, before redundancy can be sought.

There would be renationalisation of contracted out care services, and I'd look at renationalising the railways at the end of the current contracts, to avoid paying huge penalties. I have no idea what a train costs (other than being a lot of money). There will be a large increase in the provisions of social housing in new developments, with a central government department set up to purchase 50% of any new builds on these developments as part of planning permission granted, to be managed by councils and paid for by rents received. The latter would be the largest increase in spending, however would naturally be fully asset backed, ensuring no net cost to the taxpayer.

I'd also look at setting up investment and trade offices through embassies as many countries have done, to be paid for as part of the Conservatives trade directory with a small annual charge, plus a small commission on major orders negotiated directly. I'd also look to use this to encourage British investment in international companies, with the hope that we could end up with our own version of the Mittelstand in Germany; operates differently, but the theory is the same, being about planning for tomorrow instead of focusing on today.

In effect, I'd be looking at doing nothing that any of the 3 main parties are doing, which is largely focused on business and job creation as a way to get things paid for, get the deficit down and hopefully start paying down some of the debts.

With the EU, I'd be looking at an EEA agreement outside the Customs Union, to ensure we can get the best of both worlds with the departure from the EU. It's not necessarily what I'd like to see happen, however we are now where we are.

I fit very firmly into the definition of a 'swing voter', and will be looking for a party that will focus on the above, and vote with the one I feel closest to. It will likely be the Lib Dems, may be Labour, but looking at my personal priorities will be extremely unlikely to be Conservative, as I think there is disagreement on just about everything.

Feel free to pull this apart, and please take into account that I haven't costed anything, although there should be a net decline in overall costs, as anything additional should be fully paid for by revenues.

antrobus

BobQ wrote: »

..I agree it is not all about cost, efficient use of resources matter too. But the fact is we spend 8.5% of our GNP on public and private healthcare which is less than EU nations like France, Germany which are increasing their spend while we are reducing ours. ..

We are not reducing our spending on the NHS.

Health expenditure (medical services, health research, central and other health services) per capita in England has risen from £1,868 in 2010/11 to £2,057 in 2014/15.

http://www.nhsconfed.org/resources/key-statistics-on-the-nhs

Which is apart from the fact that the link you provided also confirms that NHS spending in real terms will be "increasing from £135 billion in 2014/15 to £142 billion in 2020/21".

That's not the issue. The issue is that the demands on the NHS are increasing faster than the increase of available funds. The ageing population, obesity, etc and so forth.

The simple fact is this; if you want more money for the NHS, you need to increase taxes to provide that money. Forget about all that malarkey about global multinationals or whatever, you have to increase taxes, as in put up the basic rate. That's the case that needs to be put before the British public.

BobQ

antrobus wrote: »

We are not reducing our spending on the NHS.

Health expenditure (medical services, health research, central and other health services) per capita in England has risen from £1,868 in 2010/11 to £2,057 in 2014/15.

.

Sorry I did not make it clear, we are reducing the spend on publlc/private healthcare as a % of GDP and compared to France and Germany. See the link I posted.

This suggests that either we are far more efficient than those countries or the quality of healthcare is worse?

BobQ

kabayiri wrote: »

Pens are great value, but in the hands of young children they are a potential A&E case

There's a local IT company who provide an eProcurement gateway, and count the NHS amongst their customer base.

It's a growing sector, so there is potential for a lot of savings. You don't need to build everything inhouse.

The NHS and Defence, maybe others, are now working on shared service models for many services they procure.

https://www.sbs.nhs.uk/procurement

I would be surprised if they do not buy stationery from a centralised catalogue. They are no doubt being helped by Sopra Steria's business acumen.

antrobus

BobQ wrote: »

Sorry I did not make it clear, we are reducing the spend on publlc/private healthcare as a % of GDP and compared to France and Germany. See the link I posted.

This suggests that either we are far more efficient than those countries or the quality of healthcare is worse?

Fair enough. But I think it suggests that we had a bigger problem with the deficit.

Still means that if you want to increase that NHS spend, you have to incease taxes. What's GDP these days? £472 bn for Q1 2017 it seems. So, on an annual basis, 1% of that would be £19 bn ish, that's about 4p on the basic rate. You have to make the case to the British public.