Stop voting for fucking Tories

[Dinsdale Piranha]

Also I am not sure that many folk pushing the private sector realise that the private sector trains very few if any doctors, nurses or other professions - they depend solely on NHS staff or international staff to staff their private hospitals. Without the NHS training staff then the whole of the medical provision in the UK would grind to a halt. Also if more work is shifted to the private sector then there are less training opportunities for trainees and the whole training pipeline gets blocked up and insufficient to meet demand. For example if the routine low risk work ie hip replacements or knee replacements in otherwise healthy patients goes to private sector and the NHS is left with complex case mix then the training opportunities for trainee orthopods are limited and training becomes more difficult. If they dont do enough routine cases suited for training then they dont get their training signed off.

The private sector trains most professionals in other sectors, is there any reason why it can't do so at least in part for medical staff? If more of the 'training' work is shifted to the private sector then surely it is not beyond the wit of man to transfer the training burden as well.

I appreciate this is not a trivial change and is not the way things are set up now, but surely this must happen in countries with wholly or largely largely private medical provision.

It is possible, however and for example, the US medics finish their university level studies with around £170K of debt (converted from a dollar amount I found with Google). In the UK it's currently around £70K of debt at the same stage.

As things stand private health care facilities use staff trained at our expense.

I remember as a17 year old being in the company of an adult in a college classroom (she was a mature student) who said that when she gave blood she gave it in good faith and didn't care if private patients were the recipients.

I was too timid at that age to say anything but even then I questioned why a private health care provider should profit from her act of good faith

There are things that naturally lend themselves to state provision, defence, policing, fire control, roads and travel infrastructure, utilities (the privatisation of the latter two is a disaster), education and health - we all benefit from a relatively modest contribution in these areas.

The NHS profits as they sell the blood to the private healthcare provider.

[Tichtheid]

I suspect the number of recently qualified plumbers earning £80K a year is quite low.

You do realise that junior Drs are not all newly qualified of course. They can be very senior clinicians just not consultants

And if they have been working for a few years they won't be on 15 quid an hour.

Junior doctors is indeed a not very useful descrption. I also know several who have fucked off abroad - mostly Australia - a few years after qualifying.

After graduation a doctor will be on £12.90 per hour, rising to £14.90 per hour after two years of foundation training. The average specialist training after that is four years (three for GP, 5 for general (internal medicine), at that point you start on £17.60 per hour, rising to £25.30 per hour.
my source is here

Top whack for an experienced consultant is just over the fifty quid an hour mark.

[Tichtheid]

The private sector trains most professionals in other sectors, is there any reason why it can't do so at least in part for medical staff? If more of the 'training' work is shifted to the private sector then surely it is not beyond the wit of man to transfer the training burden as well.

I appreciate this is not a trivial change and is not the way things are set up now, but surely this must happen in countries with wholly or largely largely private medical provision.

It is possible, however and for example, the US medics finish their university level studies with around £170K of debt (converted from a dollar amount I found with Google). In the UK it's currently around £70K of debt at the same stage.

As things stand private health care facilities use staff trained at our expense.

I remember as a17 year old being in the company of an adult in a college classroom (she was a mature student) who said that when she gave blood she gave it in good faith and didn't care if private patients were the recipients.

I was too timid at that age to say anything but even then I questioned why a private health care provider should profit from her act of good faith

There are things that naturally lend themselves to state provision, defence, policing, fire control, roads and travel infrastructure, utilities (the privatisation of the latter two is a disaster), education and health - we all benefit from a relatively modest contribution in these areas.

The NHS profits as they sell the blood to the private healthcare provider.

the provider marks it up and sells it at a profit to the patient.

[weegie01]

Also I am not sure that many folk pushing the private sector realise that the private sector trains very few if any doctors, nurses or other professions - they depend solely on NHS staff or international staff to staff their private hospitals. Without the NHS training staff then the whole of the medical provision in the UK would grind to a halt. Also if more work is shifted to the private sector then there are less training opportunities for trainees and the whole training pipeline gets blocked up and insufficient to meet demand. For example if the routine low risk work ie hip replacements or knee replacements in otherwise healthy patients goes to private sector and the NHS is left with complex case mix then the training opportunities for trainee orthopods are limited and training becomes more difficult. If they dont do enough routine cases suited for training then they dont get their training signed off.

The private sector trains most professionals in other sectors, is there any reason why it can't do so at least in part for medical staff? If more of the 'training' work is shifted to the private sector then surely it is not beyond the wit of man to transfer the training burden as well.

I appreciate this is not a trivial change and is not the way things are set up now, but surely this must happen in countries with wholly or largely largely private medical provision.

It is possible, however and for example, the US medics finish their university level studies with around £170K of debt (converted from a dollar amount I found with Google). In the UK it's currently around £70K of debt at the same stage.

As things stand private health care facilities use staff trained at our expense.

I remember as a17 year old being in the company of an adult in a college classroom (she was a mature student) who said that when she gave blood she gave it in good faith and didn't care if private patients were the recipients.

I was too timid at that age to say anything but even then I questioned why a private health care provider should profit from her act of good faith

There are things that naturally lend themselves to state provision, defence, policing, fire control, roads and travel infrastructure, utilities (the privatisation of the latter two is a disaster), education and health - we all benefit from a relatively modest contribution in these areas.

I agree with some of that list, but disagree with others. There is no reason why, for example, private provision of utilities and roads should be as poor as it has been here. The UK has been utterly and appallingly bad at regulating private companies and they have got away with murder. Fully private or hybrid provision can work just as effectively as fully public, and often more so, as long as they are well regulated. Different systems work well or badly in different countries and I would hate anything remotely like the US health provision, but we seem to be too quick in this country to set our faces against change for ideological reasons.

[Tichtheid]

The private sector trains most professionals in other sectors, is there any reason why it can't do so at least in part for medical staff? If more of the 'training' work is shifted to the private sector then surely it is not beyond the wit of man to transfer the training burden as well.

I appreciate this is not a trivial change and is not the way things are set up now, but surely this must happen in countries with wholly or largely largely private medical provision.

It is possible, however and for example, the US medics finish their university level studies with around £170K of debt (converted from a dollar amount I found with Google). In the UK it's currently around £70K of debt at the same stage.

As things stand private health care facilities use staff trained at our expense.

I remember as a17 year old being in the company of an adult in a college classroom (she was a mature student) who said that when she gave blood she gave it in good faith and didn't care if private patients were the recipients.

I was too timid at that age to say anything but even then I questioned why a private health care provider should profit from her act of good faith

There are things that naturally lend themselves to state provision, defence, policing, fire control, roads and travel infrastructure, utilities (the privatisation of the latter two is a disaster), education and health - we all benefit from a relatively modest contribution in these areas.

I agree with some of that list, but disagree with others. There is no reason why, for example, private provision of utilities and roads should be as poor as it has been here. The UK has been utterly and appallingly bad at regulating private companies and they have got away with murder. Fully private or hybrid provision can work just as effectively as fully public, and often more so, as long as they are well regulated. Different systems work well or badly in different countries and I would hate anything remotely like the US health provision, but we seem to be too quick in this country to set our faces against change for ideological reasons.

By definition private provision takes funding out of the service - the scandal that has water companies paying dividends in billions and it almost matching to the pound the debt they have racked up is, I think, criminal, especially with the pollution they knowingly discharge into our rivers and coastlines.

I don't have any problem with using the latest tech and efficiencies in order to provide the best service to the public for best value to the tax payer, which was always the excuse used to lobby for privatisation.

In health care the profit is the person leaving hospital well and able to continue with their life, it's not some bean counter working out how to not pay up for an operation despite an insurance policy being in place

[weegie01]

By definition private provision takes funding out of the service - the scandal that has water companies paying dividends in billions and it almost matching to the pound the debt they have racked up is, I think, criminal, especially with the pollution they knowingly discharge into our rivers and coastlines.

I don't have any problem with using the latest tech and efficiencies in order to provide the best service to the public for best value to the tax payer, which was always the excuse used to lobby for privatisation.

Private provision does not by definition take funding out of the system. There is no reason why the funding level should be any different than in a public system. The private provider is set appropriate targets and properly regulated and measured against them. If they make a profit while delivering the required service they keep it. If they make a loss it falls on them, or at least it should. In either case there is no difference to the funding compared to a public system.

Your water companies example is a perfect example of the poor regulation I was referring to. It was basically set up as a piggy bank for investors as the Govt at the time were dogmatic about privatisation so made profits pretty much inevitable no matter how bad the service. There was little incentive for providers to provide a decent service so they did not, the regulators did nothing and had little power to do anything anyway.

Edit
To be clear I am not arguing that privatisation is always the answer. What I am saying is that sometimes it can be, as can a hybrid system. Just because we or others have done it poorly in the past does not mean it should dismissed as readily as we seem to do.

[Tichtheid]

Private provision does not by definition take funding out of the system.

It has to - any surplus that could be re-invested into the system is taken out as profit.

[dpedin]

Private provision does not by definition take funding out of the system.

It has to - any surplus that could be re-invested into the system is taken out as profit.

Healthcare costs are the major reason for individual bankruptcy in the USA but it is a model no one in their right mind would support. A recent detailed study by the Kings Fund and others I think, found that changing the funding model for the NHS would be hugely disruptive, hugely expensive and not provide any better outcomes than similar healthcare systems. In short trying to shift from what we have now to another funding model would be very counter productive. We are where we are and it is about making it work better and that will inevitably mean funding it better. What is more important than the funding model is the funding per capita for healthcare and how it is spent. The UK is well below comparable spending in EU countries ie Germany, France, Switzerland, Norway, Belgium, Australia, etc. This is why we have lower bed numbers, imaging equipment and doctors and nurses per capita than these countries. The US is of course hugely more expensive than anyone else in the world ... to fund the private companies profits!

[I like neeps]

Private provision does not by definition take funding out of the system.

It has to - any surplus that could be re-invested into the system is taken out as profit.

Healthcare costs are the major reason for individual bankruptcy in the USA but it is a model no one in their right mind would support. A recent detailed study by the Kings Fund and others I think, found that changing the funding model for the NHS would be hugely disruptive, hugely expensive and not provide any better outcomes than similar healthcare systems. In short trying to shift from what we have now to another funding model would be very counter productive. We are where we are and it is about making it work better and that will inevitably mean funding it better. What is more important than the funding model is the funding per capita for healthcare and how it is spent. The UK is well below comparable spending in EU countries ie Germany, France, Switzerland, Norway, Belgium, Australia, etc. This is why we have lower bed numbers, imaging equipment and doctors and nurses per capita than these countries. The US is of course hugely more expensive than anyone else in the world ... to fund the private companies profits!

All have private sector healthcare fwiw.

I do think that with the population demands currently, we'll have to move to a European/antipodean healthcare system.

[Rhubarb & Custard]

Private provision does not by definition take funding out of the system.

It has to - any surplus that could be re-invested into the system is taken out as profit.

It also takes resources out of the public system, staff, even facilities now. That one cold argue as to whether it's a good thing on balance, but without doubt it's taking from the public system

[Paddington Bear]

Private provision does not by definition take funding out of the system.

It has to - any surplus that could be re-invested into the system is taken out as profit.

It also takes resources out of the public system, staff, even facilities now. That one cold argue as to whether it's a good thing on balance, but without doubt it's taking from the public system

This assumes that in public hands revenue would be the same. We know as a fact with the railways this wouldn’t be the case given the massive rise in passenger numbers under private operation

[Tichtheid]

It has to - any surplus that could be re-invested into the system is taken out as profit.

It also takes resources out of the public system, staff, even facilities now. That one cold argue as to whether it's a good thing on balance, but without doubt it's taking from the public system

This assumes that in public hands revenue would be the same. We know as a fact with the railways this wouldn’t be the case given the massive rise in passenger numbers under private operation

That assumes that privatisation was the reason for increased numbers.
There are a myriad of reasons for the increase, from population growth, change in living/working arrangements, numbers on roads, change in industry and numbers employed in them, to name a few

[Paddington Bear]

It also takes resources out of the public system, staff, even facilities now. That one cold argue as to whether it's a good thing on balance, but without doubt it's taking from the public system

This assumes that in public hands revenue would be the same. We know as a fact with the railways this wouldn’t be the case given the massive rise in passenger numbers under private operation

That assumes that privatisation was the reason for increased numbers.
There are a myriad of reasons for the increase, from population growth, change in living/working arrangements, numbers on roads, change in industry and numbers employed in them, to name a few

Sure, the increase is beyond minor technical changes though and isn’t in dispute within the industry. Wider point - governments the world over have often made calculations of how much a service would make them once it’s nationalised, only to fail to deliver anywhere near those numbers and in fact end up with a loss making millstone.

I can’t debate water in tonnes of detail, though I can say with water the lack of investment in reservoirs is the fault of local councils, NIMBYs and a government too scared to stand up to the both of them.

[Tichtheid]

This assumes that in public hands revenue would be the same. We know as a fact with the railways this wouldn’t be the case given the massive rise in passenger numbers under private operation

That assumes that privatisation was the reason for increased numbers.
There are a myriad of reasons for the increase, from population growth, change in living/working arrangements, numbers on roads, change in industry and numbers employed in them, to name a few

Sure, the increase is beyond minor technical changes though and isn’t in dispute within the industry. Wider point - governments the world over have often made calculations of how much a service would make them once it’s nationalised, only to fail to deliver anywhere near those numbers and in fact end up with a loss making millstone.

I can’t debate water in tonnes of detail, though I can say with water the lack of investment in reservoirs is the fault of local councils, NIMBYs and a government too scared to stand up to the both of them.

I can only find a figure for up to 2018, because the full structure of the financing of the railways is opaque to say the least, but at that point the tax payer was subsidising the railways by £5 billion per year, an increase of 200% since privatisation. Plus fares at that point were 20% higher than in 1995.

https://fullfact.org/economy/how-much-d ... -railways/

As I've said before, there is state ownership of our railways and profits gained by the state, only the states are Germany, Italy and France, perhaps Spain also - it's a while since I tried to look into this in detail - whose state-owned companies are stakeholders in our rail infrastructure, the loss-making parts are underwritten by us.

This is similar to what the Tories want for the NHS, it's what dpedin alluded to in a previous post.

[dpedin]

It has to - any surplus that could be re-invested into the system is taken out as profit.

Healthcare costs are the major reason for individual bankruptcy in the USA but it is a model no one in their right mind would support. A recent detailed study by the Kings Fund and others I think, found that changing the funding model for the NHS would be hugely disruptive, hugely expensive and not provide any better outcomes than similar healthcare systems. In short trying to shift from what we have now to another funding model would be very counter productive. We are where we are and it is about making it work better and that will inevitably mean funding it better. What is more important than the funding model is the funding per capita for healthcare and how it is spent. The UK is well below comparable spending in EU countries ie Germany, France, Switzerland, Norway, Belgium, Australia, etc. This is why we have lower bed numbers, imaging equipment and doctors and nurses per capita than these countries. The US is of course hugely more expensive than anyone else in the world ... to fund the private companies profits!

All have private sector healthcare fwiw.

I do think that with the population demands currently, we'll have to move to a European/antipodean healthcare system.

All of these have a mixed model of healthcare funding involving the state and some form of insurance scheme with contributions from individuals and employers ie National Insurance type model. However you miss the point - it is not how the funding is raised but the level of funding that is important. Although direct comparisons can be awkward all of those I mention have a higher funding per capita, or as a % of GDP if you like, and therefore can provide more beds, doctors, nurses, scanners, etc. I get it that for some of those models the funding partially automatically increases as population increases however in the UK the same could be true of the NHS if the Gov agreed to a funding model that matched weighted demand growth that takes account of both pop growth and changes in demand/age profile of users ie Children and Old folk are biggest users of healthcare. If the UK Gov funded the NHS to the same level per capita as these countries then the NHS would get significant, billions, of additional funding. The study I referred to earlier said it doesn't make much difference to the healthcare system performance how the funding is raised ie state funded NHS v insurance based scheme v hybrid models, it is the level of funding that determines overall 'success' of the system.

Sure you can improve the NHS - I would increase spend in public health particularly in early years and in dentistry, try and rebalance health and social care to get old folk out of expensive NHS beds and into care homes/care at home and increase capacity of the NHS diagnostics as a starter for 10 but all of this requires the NHS to be properly funded. Health and social care spending remains flat in real terms for the next few years despite pop growth and aging population. This Gov is essentially reducing spend per capita and running the NHS and social care into the ground! If they have their way the dentistry model of pushing folk away from NHS provision to private sector provision will be replicated in the wider NHS, many would argue this is already happening with those who can afford it skipping NHS queues and going direct to NHS trained but private sector employed provision.

[dpedin]

It also takes resources out of the public system, staff, even facilities now. That one cold argue as to whether it's a good thing on balance, but without doubt it's taking from the public system

This assumes that in public hands revenue would be the same. We know as a fact with the railways this wouldn’t be the case given the massive rise in passenger numbers under private operation

That assumes that privatisation was the reason for increased numbers.
There are a myriad of reasons for the increase, from population growth, change in living/working arrangements, numbers on roads, change in industry and numbers employed in them, to name a few

Paddington confuses correlation with causation!

[I like neeps]

Healthcare costs are the major reason for individual bankruptcy in the USA but it is a model no one in their right mind would support. A recent detailed study by the Kings Fund and others I think, found that changing the funding model for the NHS would be hugely disruptive, hugely expensive and not provide any better outcomes than similar healthcare systems. In short trying to shift from what we have now to another funding model would be very counter productive. We are where we are and it is about making it work better and that will inevitably mean funding it better. What is more important than the funding model is the funding per capita for healthcare and how it is spent. The UK is well below comparable spending in EU countries ie Germany, France, Switzerland, Norway, Belgium, Australia, etc. This is why we have lower bed numbers, imaging equipment and doctors and nurses per capita than these countries. The US is of course hugely more expensive than anyone else in the world ... to fund the private companies profits!

All have private sector healthcare fwiw.

I do think that with the population demands currently, we'll have to move to a European/antipodean healthcare system.

All of these have a mixed model of healthcare funding involving the state and some form of insurance scheme with contributions from individuals and employers ie National Insurance type model. However you miss the point - it is not how the funding is raised but the level of funding that is important. Although direct comparisons can be awkward all of those I mention have a higher funding per capita, or as a % of GDP if you like, and therefore can provide more beds, doctors, nurses, scanners, etc. I get it that for some of those models the funding partially automatically increases as population increases however in the UK the same could be true of the NHS if the Gov agreed to a funding model that matched weighted demand growth that takes account of both pop growth and changes in demand/age profile of users ie Children and Old folk are biggest users of healthcare. If the UK Gov funded the NHS to the same level per capita as these countries then the NHS would get significant, billions, of additional funding. The study I referred to earlier said it doesn't make much difference to the healthcare system performance how the funding is raised ie state funded NHS v insurance based scheme v hybrid models, it is the level of funding that determines overall 'success' of the system.

Sure you can improve the NHS - I would increase spend in public health particularly in early years and in dentistry, try and rebalance health and social care to get old folk out of expensive NHS beds and into care homes/care at home and increase capacity of the NHS diagnostics as a starter for 10 but all of this requires the NHS to be properly funded. Health and social care spending remains flat in real terms for the next few years despite pop growth and aging population. This Gov is essentially reducing spend per capita and running the NHS and social care into the ground! If they have their way the dentistry model of pushing folk away from NHS provision to private sector provision will be replicated in the wider NHS, many would argue this is already happening with those who can afford it skipping NHS queues and going direct to NHS trained but private sector employed provision.

Not quite, most European countries have healthcare tied to employment where over a (fairly low) wage threshold the employer offers private healthcare insurance and you can chose how much/little coverage to have. It's not majority taxation funded.

So because it's privately funded of course finding per capita is higher. As you say, with all the oldies and an unhealthy population the NHS is becoming underfunded compared to comparators. Sadly, I see the only way of fixing this is more insurance based healthcare like the European model.

There's an honest discussion to be had about French/Dutch/German/Australian healthcare. Sadly the NHS is too emotive to have that discussion and the ones pushing it are the right wing USA USA USA think thank freaks.

[I like neeps]

That assumes that privatisation was the reason for increased numbers.
There are a myriad of reasons for the increase, from population growth, change in living/working arrangements, numbers on roads, change in industry and numbers employed in them, to name a few

Sure, the increase is beyond minor technical changes though and isn’t in dispute within the industry. Wider point - governments the world over have often made calculations of how much a service would make them once it’s nationalised, only to fail to deliver anywhere near those numbers and in fact end up with a loss making millstone.

I can’t debate water in tonnes of detail, though I can say with water the lack of investment in reservoirs is the fault of local councils, NIMBYs and a government too scared to stand up to the both of them.

I can only find a figure for up to 2018, because the full structure of the financing of the railways is opaque to say the least, but at that point the tax payer was subsidising the railways by £5 billion per year, an increase of 200% since privatisation. Plus fares at that point were 20% higher than in 1995.

https://fullfact.org/economy/how-much-d ... -railways/

As I've said before, there is state ownership of our railways and profits gained by the state, only the states are Germany, Italy and France, perhaps Spain also - it's a while since I tried to look into this in detail - whose state-owned companies are stakeholders in our rail infrastructure, the loss-making parts are underwritten by us.

This is similar to what the Tories want for the NHS, it's what dpedin alluded to in a previous post.

I think the biggest problem with privatisation of railways is that the actual infrastructure is government run so even if they want to the private companies struggle to add more trains to match demand.

[petej]

Paddington, a basic issue with privatisation at this point is a) they need to make a profit, b) the parasitic nature of our service industries and management culture and the cost of it makes them inefficient. We spend more and more on administration and less and less on the actual service and who runs it. Compared to private healthcare in America the NHS is incredibly efficient with far, far lower administrative costs. With out sourcing work the cost of the work isn't that much but the administrative cost of two sets of commercial, financial and legal people is significant.

Edit: I would add if you are dealing with a regulatory issue go direct to the regulator and avoid consultants and legal people who make things far more painful than necessary while charging lots of money.

[petej]

Sure, the increase is beyond minor technical changes though and isn’t in dispute within the industry. Wider point - governments the world over have often made calculations of how much a service would make them once it’s nationalised, only to fail to deliver anywhere near those numbers and in fact end up with a loss making millstone.

I can’t debate water in tonnes of detail, though I can say with water the lack of investment in reservoirs is the fault of local councils, NIMBYs and a government too scared to stand up to the both of them.

I can only find a figure for up to 2018, because the full structure of the financing of the railways is opaque to say the least, but at that point the tax payer was subsidising the railways by £5 billion per year, an increase of 200% since privatisation. Plus fares at that point were 20% higher than in 1995.

https://fullfact.org/economy/how-much-d ... -railways/

As I've said before, there is state ownership of our railways and profits gained by the state, only the states are Germany, Italy and France, perhaps Spain also - it's a while since I tried to look into this in detail - whose state-owned companies are stakeholders in our rail infrastructure, the loss-making parts are underwritten by us.

This is similar to what the Tories want for the NHS, it's what dpedin alluded to in a previous post.

I think the biggest problem with privatisation of railways is that the actual infrastructure is government run so even if they want to the private companies struggle to add more trains to match demand.

Reminder that when the actual infrastructure was private we had some accidents. The need to increase capacity is well known. Even when there is capacity there still isn't enough rolling stock.

[I like neeps]

I can only find a figure for up to 2018, because the full structure of the financing of the railways is opaque to say the least, but at that point the tax payer was subsidising the railways by £5 billion per year, an increase of 200% since privatisation. Plus fares at that point were 20% higher than in 1995.

https://fullfact.org/economy/how-much-d ... -railways/

As I've said before, there is state ownership of our railways and profits gained by the state, only the states are Germany, Italy and France, perhaps Spain also - it's a while since I tried to look into this in detail - whose state-owned companies are stakeholders in our rail infrastructure, the loss-making parts are underwritten by us.

This is similar to what the Tories want for the NHS, it's what dpedin alluded to in a previous post.

I think the biggest problem with privatisation of railways is that the actual infrastructure is government run so even if they want to the private companies struggle to add more trains to match demand.

Reminder that when the actual infrastructure was private we had some accidents. The need to increase capacity is well known. Even when there is capacity there still isn't enough rolling stock.

Well yes that's why it doesn't make any sense to have privatised railways. The companies running things can't improve or expand past a certain point.

[Paddington Bear]

This assumes that in public hands revenue would be the same. We know as a fact with the railways this wouldn’t be the case given the massive rise in passenger numbers under private operation

That assumes that privatisation was the reason for increased numbers.
There are a myriad of reasons for the increase, from population growth, change in living/working arrangements, numbers on roads, change in industry and numbers employed in them, to name a few

Paddington confuses correlation with causation!

There’s clear causation here, as I say this isn’t disputed within the rail industry (not to say there aren’t major issues with the models used since privatisation)

[Paddington Bear]

Paddington, a basic issue with privatisation at this point is a) they need to make a profit, b) the parasitic nature of our service industries and management culture and the cost of it makes them inefficient. We spend more and more on administration and less and less on the actual service and who runs it. Compared to private healthcare in America the NHS is incredibly efficient with far, far lower administrative costs. With out sourcing work the cost of the work isn't that much but the administrative cost of two sets of commercial, financial and legal people is significant.

Edit: I would add if you are dealing with a regulatory issue go direct to the regulator and avoid consultants and legal people who make things far more painful than necessary while charging lots of money.

America is a terrible healthcare comparator. France/Germany/Holland are much better to compare against.

No disputes on management culture. I dispute the idea that nationalising something = same positive outcomes as privatised services with fewer negatives. Again and again nationalised industries/utilities end up a total shitshow

[epwc]

TFL seems to be fairly well run

[inactionman]

TFL seems to be fairly well run

Worth noting the tube was initially a private enterprise (more accurately, a set of private enterprises) before being nationalised.

TFL is bigger than the tube, which shows a benefit of joining up the various bits of public transport.

I do appreciate it has a degree of uniqueness, as it gets such significant funding and usage as it serves the largest conurbation in the UK.

[sefton]

This thread title is probably redundant now, Opencloset has disappeared, Paddington has gone all wet and Yourmother is standing for Likud.

Any Tories hiding in the undergrowth?

[Paddington Bear]

TFL seems to be fairly well run

Each tube line is contracted out to private companies to run in return for fixed fees. They kept the quasi-nationalised branding whilst doing so. You can see which private company operates the buses on the side of them

[inactionman]

TFL seems to be fairly well run

Each tube line is contracted out to private companies to run in return for fixed fees. They kept the quasi-nationalised branding whilst doing so. You can see which private company operates the buses on the side of them

To be honest, that should just been seen as contracting rather than privatising, and makes absolute sense. Let the contractor take care of servicing the buses, as they'll have an economy of scale and direct expertise given they'll do it for other councils/operators. but keep them away from scheduling the routes. I assume the contractors don't set fares or keep revenue, or anything much beyond getting buses on road and tube trains on lines?

The train service outsource has gone too far, when the train companies decide what their service to customer will be and what it will cost.

I'm sure the NHS contract out all sorts, from maintenance of MRI machines and cutting of the grass outside hospitals, but I believe they shouldn't allow private providers to decide healthcare or indeed to mange the delivery of said healthcare.

[I like neeps]

Great news for British politics. Although I assume the Telegraph will just turn into written GBNews with Marshall at the helm. Not that it is hugely different now anyway I guess.

[Paddington Bear]

TFL seems to be fairly well run

Each tube line is contracted out to private companies to run in return for fixed fees. They kept the quasi-nationalised branding whilst doing so. You can see which private company operates the buses on the side of them

To be honest, that should just been seen as contracting rather than privatising, and makes absolute sense. Let the contractor take care of servicing the buses, as they'll have an economy of scale and direct expertise given they'll do it for other councils/operators. but keep them away from scheduling the routes. I assume the contractors don't set fares or keep revenue, or anything much beyond getting buses on road and tube trains on lines?

The train service outsource has gone too far, when the train companies decide what their service to customer will be and what it will cost.

I'm sure the NHS contract out all sorts, from maintenance of MRI machines and cutting of the grass outside hospitals, but I believe they shouldn't allow private providers to decide healthcare or indeed to mange the delivery of said healthcare.

Yeah I agree. It’s happened with a lot of train operators since Covid and hasn’t worked so well.

It’s easy to see why, running the Victoria Line, for example, is broadly straightforward to contract, i.e. you must run a service every two minutes in each direction from Walthamstow to Brixton. It’s harder on a wider network and has left some operators frustrated that there’s no reward/incentive for increasing capacity/services on popular routes and there’s no real detriment to running a shit service with lots of cancellations (Avanti, albeit this seems to me a product of crappy contract drafting more than anything else). Probably can be made to work with a bit of thought.

[petej]

Paddington, a basic issue with privatisation at this point is a) they need to make a profit, b) the parasitic nature of our service industries and management culture and the cost of it makes them inefficient. We spend more and more on administration and less and less on the actual service and who runs it. Compared to private healthcare in America the NHS is incredibly efficient with far, far lower administrative costs. With out sourcing work the cost of the work isn't that much but the administrative cost of two sets of commercial, financial and legal people is significant.

Edit: I would add if you are dealing with a regulatory issue go direct to the regulator and avoid consultants and legal people who make things far more painful than necessary while charging lots of money.

America is a terrible healthcare comparator. France/Germany/Holland are much better to compare against.

No disputes on management culture. I dispute the idea that nationalising something = same positive outcomes as privatised services with fewer negatives. Again and again nationalised industries/utilities end up a total shitshow

They are at least then a shitshow we own and depressingly pumped less money into. With water we could end up 60billion of debt while a bunch of cunts wander off with 60 billion. A big problem with the current gov is they are so ideologically fixed on privatisation they won't enforce the rules and the water companies are essentially playing chicken with them knowing the government are weak.

[Paddington Bear]

Paddington, a basic issue with privatisation at this point is a) they need to make a profit, b) the parasitic nature of our service industries and management culture and the cost of it makes them inefficient. We spend more and more on administration and less and less on the actual service and who runs it. Compared to private healthcare in America the NHS is incredibly efficient with far, far lower administrative costs. With out sourcing work the cost of the work isn't that much but the administrative cost of two sets of commercial, financial and legal people is significant.

Edit: I would add if you are dealing with a regulatory issue go direct to the regulator and avoid consultants and legal people who make things far more painful than necessary while charging lots of money.

America is a terrible healthcare comparator. France/Germany/Holland are much better to compare against.

No disputes on management culture. I dispute the idea that nationalising something = same positive outcomes as privatised services with fewer negatives. Again and again nationalised industries/utilities end up a total shitshow

They are at least then a shitshow we own and depressingly pumped less money into. With water we could end up 60billion of debt while a bunch of cunts wander off with 60 billion. A big problem with the current gov is they are so ideologically fixed on privatisation they won't enforce the rules and the water companies are essentially playing chicken with them knowing the government are weak.

I agree that there is no reason at all to leave TW’s creditors with anything but their dick in their hands. Nationalised water had a dismal record though!

[petej]

America is a terrible healthcare comparator. France/Germany/Holland are much better to compare against.

No disputes on management culture. I dispute the idea that nationalising something = same positive outcomes as privatised services with fewer negatives. Again and again nationalised industries/utilities end up a total shitshow

They are at least then a shitshow we own and depressingly pumped less money into. With water we could end up 60billion of debt while a bunch of cunts wander off with 60 billion. A big problem with the current gov is they are so ideologically fixed on privatisation they won't enforce the rules and the water companies are essentially playing chicken with them knowing the government are weak.

I agree that there is no reason at all to leave TW’s creditors with anything but their dick in their hands. Nationalised water had a dismal record though!

I would probably run them as not for profits rather then fully nationalised.

[epwc]

Probably can be made to work with a bit of thought.

That could be applied to just about everything government does at the moment

[sockwithaticket]

Great news for British politics. Although I assume the Telegraph will just turn into written GBNews with Marshall at the helm. Not that it is hugely different now anyway I guess.

Turn into...?

Admittedly I haven't subjected myself to watching any of GBeebies, so perhaps it is indeed worse than even the Torgraph at it's current swivel-eyed nadir.

[SaintK]

I'm sure she'll feel right at home.

Rishi Sunak is being urged to stop his former home secretary from attending a rightwing convention featuring figures who have been under investigation for extremism, in the latest sign of his waning control of his party.
Suella Braverman, who has been a central plotter against the prime minister since she left the cabinet, is set to be one of the keynote speakers at the National Conservatism (NatCon) conference in Brussels this week.

https://www.theguardian.com/politics/ ... ktor-orban

[C69]

Rayner to step down if found guilty of a crime.
Whilst I personally dislike Rayner, if she is found to have no case to answer then this may really bite the Tories in the arse.
Hopefully this distraction is sorted quickly.
It all seems quite vindictive and petty tbh but hey this is going to get very dirty.

[sefton]

I'm sure she'll feel right at home.

Rishi Sunak is being urged to stop his former home secretary from attending a rightwing convention featuring figures who have been under investigation for extremism, in the latest sign of his waning control of his party.
Suella Braverman, who has been a central plotter against the prime minister since she left the cabinet, is set to be one of the keynote speakers at the National Conservatism (NatCon) conference in Brussels this week.

https://www.theguardian.com/politics/ ... ktor-orban

She can be added to Gove’s list.

[Hal Jordan]

Rayner to step down if found guilty of a crime.
Whilst I personally dislike Rayner, if she is found to have no case to answer then this may really bite the Tories in the arse.
Hopefully this distraction is sorted quickly.
It all seems quite vindictive and petty tbh but hey this is going to get very dirty.

Nine more months of it until the election.

[Uncle fester]

Rayner to step down if found guilty of a crime.
Whilst I personally dislike Rayner, if she is found to have no case to answer then this may really bite the Tories in the arse.
Hopefully this distraction is sorted quickly.
It all seems quite vindictive and petty tbh but hey this is going to get very dirty.

Police weren't going to charge her until tories kicked up a fuss?