Is it time to privatise the ever failing NHS...

Has much I like starmer don't think he should go further down the private road.

The private care system only take on what they can make money on .

And Basically the patient comes
Second

the patient comes second under the NHS - we just had a massive campaign for people to stay away and protect the NHS.

I would prefer a health system where it is the patient that is protected and not the system..

I agree. And, as for Vegas, major trade shows tend to be held in major cities rather than nondescript towns.

Experience with other privatisations clearly show that they often make things worse and not better. Part of the problem the NHS has is too much private sector involvement sucking money out of it already.

Yes the NHS is failing badly in its current form, starved of the necessary funds and understaffed due to ever worsening real terms pay. It badly needs reform. Pay and recruitment needs to be looked at. We need fewer managers and more frontline staff. We need to train many more doctors and nurses and find ways to incentivise them working in the NHS. And when the entire NHS is on its knees, we should not be allowing managers to waste our money on shite. Someone needs to be empowered to rein that in. Some form of reform is necessary. But we should not equate reform with ever more marketisation and privatisation. Because what we will get is more pen pushers and bean counters paid for by more cuts to frontline staff on the name of "efficiency".

Occasionally you can sound sensibly leftish when speaking from personal experience, ie real life.

It’s nice to see nearly two pages of relatively sober discussion on this, rather than the usual partisan mud-slinging.

For me, I have always maintained that I don’t care how the NHS is funded as long as it remains universal in nature and we don’t end up with people being left bankrupt for the misfortune of ill health.


100%. Many of my former students feed back to me their frustration at not being able to deliver the high-quality, patient-centred care we teach them, due to lack of resources both in terms of medical equipment and staff.


I was just leaving the NHS to go to MoD when these 'New Public Management' initiatives to devolve budgets down to ward and department level came in. Until then, all senior nurses had to concern themselves with was making sure that patients got the care they needed. The financial aspects of that care were for people in suits in the hospital HQ and it was their job to sort out. More egregious, however, was the tying of annual appraisal to budgetary management as a priority, in other words for senior clinical managers, patient care could go hang as long as you stayed within budget. I made the move to MoD at the right time. All the way up to my exit point in 2022, my role as a senior clinical manager was never fettered by a budget. My priority was always high-quality healthcare delivery, not keeping bean-counters happy.


This does, however, impact on the quality of the service provided by private sector companies like Sodexho, ISS et al. Public sector contracts are reviewed every 5 years and every time they come up for renewal, government procurement rules require them to offer to the lowest bidder. As a result, the level and quality of service goes progressively down and down as each contract is renewed. I’ve seen it in both the NHS and the MoD.


The other thing is that, as a manager, I could directly manage everyone on my team when all of them were in-house, whereas as soon as I was reliant on contractors I could do little to nothing about their poor work standards and attitude because they didn’t work for me. I had many a convoluted and extended phone/email conversation with some ‘manager’ hundreds of miles away, that inevitable failed to resolve the problem.

New Public Management


As an aside, we were only talking yesterday at work about how the quality and efficiency of our nurse training programme has been adversely affected by the nearly forty-year evolution of NPM principles. Now nursing is a degree programme, it has to be managed like any other degree, which means that the student is the 'customer'. BUT - and not just for nursing, but also all other AHP courses - we as nurse teachers are statutorily required to deliver what the Nursing and Midwifery Council tells us to deliver. So when bleating students whinge about their course and start waving their 'I'm paying nine and a half grand a year for this' card, that puts us in an invidious position. Our scores on things like the National Student Survey can be affected by our 'unresponsiveness' to student complaints, but there's fuck all we can do about it because we HAVE to deliver what our statutory governing body says we have to deliver, not deliver whatever the students' fancy.

I can relate to that but the other way round. I work for a private contractor, but back in lockdown one 2020 we got seconded to training Universal Credit for the DWP. We had to deliver the DWP training materials in the DWP format and it was absolutely horrendous, just reading stuff out to groups of 25, little interactivity and no live experience. Just awful. Totally agreed with the complaints, but we had no say in it.