the snap general election thread

gfplux

.string. wrote: »

That was a really good input, giving that link which gives detailed benchmarks to be used by medical centres by which to judge their own performance.

The sharp end is in principle given by QIPP
http://ukpolicymatters.thelancet.com/qipp-programme-quality-innovation-productivity-and-prevention/

although that is rather high level explanation, it will be interesting (for me) to delve into the really pointed detail which hopefully will give advice on how hospitals can, for example, reduce waiting times. But that will have to wait until I get my hands on my desktop again, serious web searching is not really practical in the thing I'm using at present.

Some of the things I would be interested in are

1. Waiting times --- I start with a slightly inaccurate hypothesis but one which has enough truth in it to be taken seriously

If waiting times are stable at a certain delay time and if resources are static, the the extent of the delay is a measure of the quality of the as administration..

To explain, if the delay is static then the resources (Staff, money, facilities) are keeping pace with the demand and thus the gaps between appointments, diagnosis, etc are due to the time it takes to administer the process.

I've lived in Holland and during that time on a number of occasions had X-rays to assist diagnosis. In many of those immediately after the X-ray is as soon as I was dressed, I saw a medical person (not the super duper consultant) who was nevertheless qualified as specialist, who told me the result and whether I needed to see the consultant for further investigation . So in the couple of cases when that was the case I needed no further treatment, I was informed fully before I left the hospital and I've no doubt it was a low cost process and certainly shorter compared with that of waiting for another appointment and so on and so forth.

The point is that delay can be helped by better administration and better use of resources.

2. I have a thing about medical hierarchy in the medical profession. In the example above, the consultant was not the person who could make a judgement, it was a "lower ranked" doctor. I think more use could be made of alocating responsibilities to lower levels, all the way from giving chemists the ability to advise on medicine for some medical complaints. Also the matter of sign-off (approval for procedures, payment, whatever) is something that can produce efficiencies. That's more complicated but can produced startling improvements as I've found in my professional life. Basically it comes down to delegating responsibilities. In any large organisation, as per Parkinson, there is a tendancy for individuals to hoard responsibility for approvals.

3. The matter of "Moonlighting" where an NHS doctor can sell his/her services to private health care thereby denying the NHS patience the same service. I'm not against a symbiosis between National and Private health care, but it needs to be managed better so that the NHS benefits.

Very interesting and logical.
Your point about a lower level of advise after a scan etc.
This also is the case in Luxembourg.
In the 80's/90's I was handed a CD disc or in the case of x ray the actual film to take to my Specialist/GP. Since 2000 +\- the results are sent immediately by email.
When my GP takes blood the results are back in his hands in 24 hours and (I think very important) I get a copy sent directly to me. A short phone call between doctor and patient then occurs the next day.
When I lived in the U.K. I was "fortunate" to experience private and NHS care. The principle difference I now reflect upon is the NHS the results of tests were "almost" secret from me the patient. The private sector wanted me to have a copy of the results as soon as possible (to justify sending a bill of course)

gfplux

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?

I am biting my tongue because I have been flamed when I "might" have hinted at my experience.

There is a tendency to blame the messenger here.

sevenhills

antrobus wrote: »

That NHS confederation source I cited, seems to claim otherwise.

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

It talks about funding, and population - but I cannot see where it states funding per patient.

sevenhills

antrobus wrote: »

PFI was invented by the Major government, and did a few deals in the 1990s. Naturally, the Labour Party pronounced them to be a very bad thing. Of course, as soon as Labour got back into government, the use of PFI exploded. Naturally, the Conservative Party pronounced this to be a very bad thing. Of course, as soon as the Cons got back into government, what they did was carry on with PFI. (I think it was rebranded as 'new PFI' or something like that.)

PFI is basically leasing. It's attractive to governments because it's a way of borrowing money without increasing the national debt.:)

I dont disagree with that. But you were using PFI to bash Labour, which was false.

antrobus

sevenhills wrote: »

It talks about funding, and population - but I cannot see where it states funding per patient.

Neither do I. But then neither did Simon Stevens, who (according to you) said “in 2018-19, real-terms NHS spending per person in England is going to go down”.

A_Pict_In_A_Past_Life

gfplux wrote: »

I am biting my tongue because I have been flamed when I "might" have hinted at my experience.

There is a tendency to blame the messenger here.

Not exactly.
There is a tendency to decry what some attempt to tell us is the norm when in fact it is an exception.

My experiences (and there are quite a few) have without exception been positive if not always the exceptionally good which are the norm from my POV.

antrobus

sevenhills wrote: »

I dont disagree with that. But you were using PFI to bash Labour, which was false.

I was not bashing anybody. I was simply pointing out that the Labour government of 1997-2010 signed up a lot of PFI deals.

For what it's worth, the Wiki page on PFI states that "PFI expanded considerably in 1996 and then expanded much further under Labour"

https://en.wikipedia.org/wiki/Private_finance_initiative#United_Kingdom

Or you can look at this, from the Guardian Datablog, which has a full list of PFI projects and their annual cost, which you can look at on Google Docs . There is bog all before 1997, but see that Unitaty charge payment figure explode from 1997-98 onwards.

https://www.theguardian.com/news/datablog/2012/jul/05/pfi-contracts-list

Facts are sacred.:)

CKhalvashi

http://www.irishtimes.com/news/world/uk/tory-suspended-as-racist-tweet-follows-irish-eurovision-vote-1.3082703

Whoops.......

On a side note, Lucie sang brilliantly (click here), and even though I don't usually say this about a UK entry, was screwed by the televote, after finishing on the left side in the jury vote.

She also gained a well deserved standing ovation.

CKhalvashi

antrobus wrote: »

I was not bashing anybody. I was simply pointing out that the Labour government of 1997-2010 signed up a lot of PFI deals.

For what it's worth, the Wiki page on PFI states that "PFI expanded considerably in 1996 and then expanded much further under Labour"

https://en.wikipedia.org/wiki/Private_finance_initiative#United_Kingdom

Or you can look at this, from the Guardian Datablog, which has a full list of PFI projects and their annual cost, which you can look at on Google Docs . There is bog all before 1997, but see that Unitaty charge payment figure explode from 1997-98 onwards.

https://www.theguardian.com/news/datablog/2012/jul/05/pfi-contracts-list

Facts are sacred.:)

Both have used PFI deals.

Not in agreement with that, however it's not something we can go for or against either party on. That includes my own, who formed part of a government that used such deals as a way of financing.

kabayiri

CKhalvashi wrote: »

...
On a side note, Lucie sang brilliantly (click here), and even though I don't usually say this about a UK entry, was screwed by the televote, after finishing on the left side in the jury vote.

She also gained a well deserved standing ovation.

Nobody I know cares about Eurovision anymore.

It was a novelty perhaps in different times, but today we have so many talent shows. It's a crowded space.

Even something like Britains Got Talent attracts contestants from around Europe / the World. It also attracted 9 million viewers compared to Eurovision 6 million.

Eurovision should move to a pay channel.