Politics

[ChezGiven 0]

Targets are absolutely utterly essential in any public service. This is why:

 

When you are an investor with capital looking at a range of alternative choice of where to put your money (a new factory, a new machine, a new company, a stock etc), you perform a return on investment calculation.

 

Just like the virtually unlimited choices faced by the private investor, a public investor (ie. a public service) is also faced with a range of choices. For example the Dept of Transport has a number of alternative choices regarding new motorway investments. The decision over which to take (we cant do them all) will be based on a cost-benefit appraisal looking to maximise economic benefits from a given level of investment (the term used is technical efficiency). How do you measure the benefits of the new motorway? Well, probably a lot easier than you think as most of the benefits can be measure using economic variables and indicators.

 

Now apply the same desire to use money in an efficient way to healthcare spending. What metrics are you going to use to determine how well money is being spent? If you have a choice between building a hospital or investing in 3 new outpatient clinics, which one would you choose and why? (this question was the first i was asked when i was interviewed by the head of the Govt economic service)

 

The question was first posed by Archie Cochrane and Alan Williams when they were both seconded to the DoH in the 60s. They proposed that decisions taken in the DoH should be consistent with those taken in the Dept of Transport. That public expenditure should be formally related to its benefits. The intractable problem in healthcare is measuring benefits (and for the purposes of investment putting them into the same currency so that alternatives could be compared). Targets are one way of ensuring that money spent is related to what the healthcare system is trying to acheive, ie better health.

 

Therefore, a healthcare system that does not measure its activity and relate that activity to its cost base is one that is run by retards who should not be in charge of spending our taxes. In short, there is no debate (in the DoH anyway) on whether to use them but only on which ones to use and how.

 

 

Coming from a business background Im all too familiar with being able to "measure" as much as possible, be it sales persons performance, product performance or ruturn on advertising spend etc etc.

 

But...

 

We there are some truths that need adding in to your logical argument.

 

1. There is no money left.

 

Somethings going to have to give. Frontline or backroom?

 

 

2. As in all walks of life there will be good targets and stupid targets.

 

Anyone who has worked for a company will know all about departmental empire builders. Just look at your average Personnel department over the last 15 years or so. Staffing laws, health and safety, risk assesment, training.....an endless list that increases year on year as "managers" think up something else we should be "measuring".

 

 

3. The cost to taxpayer / patients and health workers time on meeting those targets.

 

I would never have taken by best salesperson off the shop floor to stand at the door and count the number of customers coming in or walking by...It used to happen. Similarly how much of a health workers time is taken up filling out targets, monitoring timespans etc. The same is very often mentioned by police officers.

 

In 2010, we will spend 9% of GDP on healthcare, thats a lot of money. So point 1 is just gibberish.

 

Point 2 is about economic choices, the reason why you need to related inputs (money) to outputs (health) so that the choice is the best for the taxpayer.

 

Point 3 is vaild and is in line with my last sentence, its about which targets are used and how they are used. Its not 'targets' that are the problems its 'bad targets'.

 

To be very clear on this, let me ask the question. If Osborne promised to reduce spending without affecting frontline services, how are you going to prove that this statement is right, that he is not a liar, in 12 or 24 months time? Are you going to ask frontline staff what they think?

[Renton 21627]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

 

Just chatting about this at lunch. The clinicians are all agreed that the targets are being removed as a prelude to reducing the quality of service. Makes perfect sense if you think about it.

 

Btw CT, Cameron had promised the NHS would not be affected by his cuts. Looks like that was a lie then.

[ChezGiven 0]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

aye right. Cost to whom? The cost to ASDA? Then you mean at their wholesale price. Which is what the NHS currently pays.

[Christmas Tree 4725]

Targets are absolutely utterly essential in any public service. This is why:

 

When you are an investor with capital looking at a range of alternative choice of where to put your money (a new factory, a new machine, a new company, a stock etc), you perform a return on investment calculation.

 

Just like the virtually unlimited choices faced by the private investor, a public investor (ie. a public service) is also faced with a range of choices. For example the Dept of Transport has a number of alternative choices regarding new motorway investments. The decision over which to take (we cant do them all) will be based on a cost-benefit appraisal looking to maximise economic benefits from a given level of investment (the term used is technical efficiency). How do you measure the benefits of the new motorway? Well, probably a lot easier than you think as most of the benefits can be measure using economic variables and indicators.

 

Now apply the same desire to use money in an efficient way to healthcare spending. What metrics are you going to use to determine how well money is being spent? If you have a choice between building a hospital or investing in 3 new outpatient clinics, which one would you choose and why? (this question was the first i was asked when i was interviewed by the head of the Govt economic service)

 

The question was first posed by Archie Cochrane and Alan Williams when they were both seconded to the DoH in the 60s. They proposed that decisions taken in the DoH should be consistent with those taken in the Dept of Transport. That public expenditure should be formally related to its benefits. The intractable problem in healthcare is measuring benefits (and for the purposes of investment putting them into the same currency so that alternatives could be compared). Targets are one way of ensuring that money spent is related to what the healthcare system is trying to acheive, ie better health.

 

Therefore, a healthcare system that does not measure its activity and relate that activity to its cost base is one that is run by retards who should not be in charge of spending our taxes. In short, there is no debate (in the DoH anyway) on whether to use them but only on which ones to use and how.

 

 

Coming from a business background Im all too familiar with being able to "measure" as much as possible, be it sales persons performance, product performance or ruturn on advertising spend etc etc.

 

But...

 

We there are some truths that need adding in to your logical argument.

 

1. There is no money left.

 

Somethings going to have to give. Frontline or backroom?

 

 

2. As in all walks of life there will be good targets and stupid targets.

 

Anyone who has worked for a company will know all about departmental empire builders. Just look at your average Personnel department over the last 15 years or so. Staffing laws, health and safety, risk assesment, training.....an endless list that increases year on year as "managers" think up something else we should be "measuring".

 

 

3. The cost to taxpayer / patients and health workers time on meeting those targets.

 

I would never have taken by best salesperson off the shop floor to stand at the door and count the number of customers coming in or walking by...It used to happen. Similarly how much of a health workers time is taken up filling out targets, monitoring timespans etc. The same is very often mentioned by police officers.

 

In 2010, we will spend 9% of GDP on healthcare, thats a lot of money. So point 1 is just gibberish.

 

Point 2 is about economic choices, the reason why you need to related inputs (money) to outputs (health) so that the choice is the best for the taxpayer.

 

Point 3 is vaild and is in line with my last sentence, its about which targets are used and how they are used. Its not 'targets' that are the problems its 'bad targets'.

 

To be very clear on this, let me ask the question. If Osborne promised to reduce spending without affecting frontline services, how are you going to prove that this statement is right, that he is not a liar, in 12 or 24 months time? Are you going to ask frontline staff what they think?

 

First of all, have you been on Mars every department is facing cuts, regardless of gdp so simply saying "its a lot of money" is like something I would say

 

With regard to your last paragraph, I think the phrase they used was "without cutting not affecting".

[ChezGiven 0]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

[Christmas Tree 4725]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

 

Just chatting about this at lunch. The clinicians are all agreed that the targets are being removed as a prelude to reducing the quality of service. Makes perfect sense if you think about it.

 

Btw CT, Cameron had promised the NHS would not be affected by his cuts. Looks like that was a lie then.

 

 

Charlie and the Docs on Casualty hate the targets.

[Renton 21627]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

 

Just chatting about this at lunch. The clinicians are all agreed that the targets are being removed as a prelude to reducing the quality of service. Makes perfect sense if you think about it.

 

Btw CT, Cameron had promised the NHS would not be affected by his cuts. Looks like that was a lie then.

 

 

Charlie and the Docs on Casualty hate the targets.

 

I suppose you enjoy waiting in casualty for more than 4 hours, or having your elective coronary bypass operation postponed indefinitely?

[Christmas Tree 4725]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

aye right. Cost to whom? The cost to ASDA? Then you mean at their wholesale price. Which is what the NHS currently pays.

 

Not sure what the smileys for????

 

I dont think they are trying to compete with the NHS more compete with other organisations / chemists who charge individulas a lot more, ie for profit.

 

Asda has announced it will sell all privately-prescribed cancer treatment drugs on a not-for-profit basis.

 

The crippling cost of paying privately for cancer treatment has forced many people to spend their savings or even re-mortgage their house to pay for these essential drugs.

 

"We are the first retailer to recognise this injustice and to do something about it and we are calling on other retailers to follow our lead.

 

"It's a small step in the right direction but our permanent 'not for profit' price on cancer treatment drugs makes them more accessible and can save people hundreds if not thousands of pounds."

[Christmas Tree 4725]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

 

I cant believe your seriously putting up this sort of rhetoric :)

 

What do you think the defecit is? The difference between money in to the government and money out.

 

If we have a defecit then surely its because we havent got enough to pay our bills.

[NJS 4386]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

 

It's the new Tory catchphrase - what it means is "we now have the chance to do exactly what we've always wanted" knowing that the gullible will swallow this "we're broke" shite.

 

In 5 years time CT how will they be able to answer the question "Is the NHS better or worse?"

[NJS 4386]

If we have a defecit then surely its because we havent got enough to pay our bills.

 

Haven't had (past tense) because times were shit - unless Osbourne fucks it, we will have enough.

[Christmas Tree 4725]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

 

Just chatting about this at lunch. The clinicians are all agreed that the targets are being removed as a prelude to reducing the quality of service. Makes perfect sense if you think about it.

 

Btw CT, Cameron had promised the NHS would not be affected by his cuts. Looks like that was a lie then.

 

 

Charlie and the Docs on Casualty hate the targets.

 

I suppose you enjoy waiting in casualty for more than 4 hours, or having your elective coronary bypass operation postponed indefinitely?

 

Nope, but I would rather Charlie and his mates finish off stitching your stab wound up rather than leaving you too wait because Kevins ingrowing toenail that he rediculously attended casualty with has been waiting 3 hours and 55 minutes.

[Christmas Tree 4725]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

 

It's the new Tory catchphrase - what it means is "we now have the chance to do exactly what we've always wanted" knowing that the gullible will swallow this "we're broke" shite.

 

In 5 years time CT how will they be able to answer the question "Is the NHS better or worse?"

 

Labour catchphrase actually

 

You all seem to miss the point.

 

The tories would much rather be taking over an economy that was booming with a manageable debt and a surplus not a defecit.

 

That would allow them to concentrate on improvements, tweaks, new ideas.....Unfortunately AS ALWAYS happens, Labour has left power once again with the country on its knees.

 

You really should try and sweep past these very true and important points.

[Christmas Tree 4725]

If we have a defecit then surely its because we havent got enough to pay our bills.

 

Haven't had (past tense) because times were shit - unless Osbourne fucks it, we will have enough.

 

 

No we wont. No political party is reccomending no cuts or no tax rises. NONE.

[Renton 21627]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

 

Just chatting about this at lunch. The clinicians are all agreed that the targets are being removed as a prelude to reducing the quality of service. Makes perfect sense if you think about it.

 

Btw CT, Cameron had promised the NHS would not be affected by his cuts. Looks like that was a lie then.

 

 

Charlie and the Docs on Casualty hate the targets.

 

I suppose you enjoy waiting in casualty for more than 4 hours, or having your elective coronary bypass operation postponed indefinitely?

 

Nope, but I would rather Charlie and his mates finish off stitching your stab wound up rather than leaving you too wait because Kevins ingrowing toenail that he rediculously attended casualty with has been waiting 3 hours and 55 minutes.

 

Why can't Charlie do both?

 

Actually, Charlie can fuck right off, he's the nost annoying character in the history of television.

[ChezGiven 0]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

 

I cant believe your seriously putting up this sort of rhetoric :)

 

What do you think the defecit is? The difference between money in to the government and money out.

 

If we have a defecit then surely its because we havent got enough to pay our bills.

 

We have money to spend and the deficit is funded by the lowest rates of interest in history. If we grow the economy we can pay it back.

 

The point is, we have access to capital to fund the deficit and have a huge budget to spend. 'There is no money left' is rubbish.

[NJS 4386]

You all seem to miss the point.

 

The tories would much rather be taking over an economy that was booming with a manageable debt and a surplus not a defecit.

 

That would allow them to concentrate on improvements, tweaks, new ideas.....Unfortunately AS ALWAYS happens, Labour has left power once again with the country on its knees.

 

You really should try and sweep past these very true and important points.

 

 

If the debt wa unmanageble the hawks would have attacked it as they have the Greek and Spanish debts.

 

I'm not saying it's okay or shouldnt be addressed - I'm just saying its not armageddon.

 

I'd also rather have the country on its knees after 11 years of of a boom, 2 leading to 4 years of shit looking forward (note the new body said Labour's plan would have worked) than being left for dead in the gutter by the Tories.

[ChezGiven 0]

NHS Targets on their way out.

 

First ones on their way seem to be the requirement for GPs to see people within 48 hours, the four-hour A&E target and the 18-week waiting target.

 

They form part of a drive to save money on management costs across the health service and reflect a major shift from how the NHS operated under Labour.

 

But in the lead up to the election the Tories claimed it was time to move away from the target culture and instead focus more on the quality of treatment.

 

Mr Lansley said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.

 

"Doctors will be free to focus on the outcomes that matter - providing quality patient care."

 

Whats the word inside the NHS Renton about the general target culture?

 

It's not really my concern but I fail to see how you can improve quality of care without having objective targets. The NHS is certain to decline under this government.

 

Of more interest to me from a personal point of view is what happens to NICE. Rumours are afoot big changes are coming, none of which will be good imo.

 

 

Fair enough I was mainly asking from an insiders point of view as to how the targets culture over the last few years had gone down. Thought it may have been the sort of stuff you discussed with the nurses and doctors in the canteen over lunch.

 

Naah, I'm quite detached from the clinical realities of the NHS really. I'm more involved with clinical effectivenss of interventions, and more recently cost effectiveness.

 

Seriously though, I'm not being partisan here when I say this government doesn't seem to have a clue what its doing regarding healthcare. For instance, before the election, Cameron promised a chest of money for the provision of cancer treatments. This just sounds like popularist bullshit to me. Early days still, we'll see soon enough.

 

 

If your not been partisan then you'll agree their decisions have being reduced somewhat by the state of the countries finances.

 

Have you also noted that Asda is to start selling all Cancer drugs at cost.

aye right. Cost to whom? The cost to ASDA? Then you mean at their wholesale price. Which is what the NHS currently pays.

 

Not sure what the smileys for????

 

I dont think they are trying to compete with the NHS more compete with other organisations / chemists who charge individulas a lot more, ie for profit.

 

Asda has announced it will sell all privately-prescribed cancer treatment drugs on a not-for-profit basis.

 

The crippling cost of paying privately for cancer treatment has forced many people to spend their savings or even re-mortgage their house to pay for these essential drugs.

 

"We are the first retailer to recognise this injustice and to do something about it and we are calling on other retailers to follow our lead.

 

"It's a small step in the right direction but our permanent 'not for profit' price on cancer treatment drugs makes them more accessible and can save people hundreds if not thousands of pounds."

 

What this statement means is that for those in the population lucky to have private health insurance, ASDA will sell the cancer drugs without a mark-up.

 

Thats not 'at cost'. There is no way of ASDA being sold anything 'at cost' since they are charged the wholesale price. They can add a mark-up to the wholesale price, which affects the level of co-payment the privately insured patients pays through the insurance scheme.

 

What this does is removes a very small % profit from an absolutely tiny percentage of cancer patients without affecting public provision issues one iota.

 

Thats why i was laughing.

[Christmas Tree 4725]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

 

I cant believe your seriously putting up this sort of rhetoric :)

 

What do you think the defecit is? The difference between money in to the government and money out.

 

If we have a defecit then surely its because we havent got enough to pay our bills.

 

 

Translation

 

We have money to spend and the deficit is funded by the lowest rates of interest in history. If we grow the economy we can pay it back.

 

My credit card limits just been increased as part of my 3 month o% balance transfer deal. If things look up, I'll pay it off.

 

The point is, we have access to capital to fund the deficit and have a huge budget to spend. 'There is no money left' is rubbish.

 

As long as people keep offering me credit to fund my overspending theres lots left to buy in the argos catalogue.

 

Breathtakingly amazing

Edited June 21, 2010 by Christmas Tree

[Christmas Tree 4725]

Britons expect the economy to deteriorate over the next year but are optimistic that the coalition government's policies will pay off eventually, a poll showed on Monday.

 

The Reuters/Ipsos MORI poll, released on the eve of what is expected to be the toughest budget in a generation, also showed Prime Minister David Cameron enjoyed an approval rating of 57 percent after just over a month in the job.

 

Forty percent of those surveyed thought that the economic condition of the country would get worse over the next year, while only 35 percent saw an improvement.

 

However, 61 percent of those surveyed believed the new government's policies would improve the state of Britain's economy in the long term, against 29 percent who disagreed.

 

Three in five people agreed that the government was being honest about the state of public finances, a sign that the government's warnings of hard times to come have hit home.

[Renton 21627]

Britons expect the economy to deteriorate over the next year but are optimistic that the coalition government's policies will pay off eventually, a poll showed on Monday.

 

The Reuters/Ipsos MORI poll, released on the eve of what is expected to be the toughest budget in a generation, also showed Prime Minister David Cameron enjoyed an approval rating of 57 percent after just over a month in the job.

 

Forty percent of those surveyed thought that the economic condition of the country would get worse over the next year, while only 35 percent saw an improvement.

 

However, 61 percent of those surveyed believed the new government's policies would improve the state of Britain's economy in the long term, against 29 percent who disagreed.

 

Three in five people agreed that the government was being honest about the state of public finances, a sign that the government's warnings of hard times to come have hit home.

 

Most 'Britons' are idiots like you though.

[Kevin Carr's Gloves 3894]

The phrase 'there is no money left' is bollocks. We are a very rich country. We might not be growing but we stopped shrinking and the level we stopped at is still one of the richest countries in the world.

 

This year we will continue to spend mind-boggling amounts of money on defence, social security, health etc. The idea that there is no money left is stupid.

 

I cant believe your seriously putting up this sort of rhetoric :)

 

What do you think the defecit is? The difference between money in to the government and money out.

 

If we have a defecit then surely its because we havent got enough to pay our bills.

 

We have money to spend and the deficit is funded by the lowest rates of interest in history. If we grow the economy we can pay it back.

 

The point is, we have access to capital to fund the deficit and have a huge budget to spend. 'There is no money left' is rubbish.

 

The British govt owes 900 billion pounds and some economists estimate that will rise to 1.1 trillion in 2011. Last year the gap between what the govt took in from earnings and what it spent was 170 billion the amount it borrowed. This does not however include the spending done through PFI as that is not official borrowing. To put that into perspective in my council of South Lanarkshire the local government has to pay 30 million a year ofr the next 30 years for the 17 schools which have been built. I would imagin as a medium size council this would be the national average. So we owe a trillion pounds and still have to borrow to make up the shortfall on what we spend. Oh and just to rub salt in the wounds the last round of PFI spending was dogged by the companies not having the cash to stump up for it. So as a result and not wishing to be shown to be a mong Gordon Brown gave permission to the treasury to loan money to the PFI companies so they could loan it back to the government at a mark up rate.

 

So yes we are rich as Croesus. Or should that be Greece?

[ChezGiven 0]

What's your point KCG?

[Christmas Tree 4725]

What's your point KCG?

 

Huston, we have a problem!

 

Take your head out the sand!

 

Your in denial!

 

(delete as appropriate)

[NJS 4386]

It's no good just repeating the "we owe billions" mantra unless you compare it with other countries. We don't come off that bad and are a million miles away from Greece. Even mentioning them shows that you are just spouting Cameron's shit.