Also in the News - Part 2

[urban.spaceman]

All i wanted was a siege in a bush with Gazza turning up with a fishing rod and some chicken.

 

Gutted. 

[urban.spaceman]

“Most escaped prisoners have been caught”

[Tuna]

8 minutes ago, urban.spaceman said:

All i wanted was a siege in a bush with Gazza turning up with a fishing rod and some chicken.

 

Gutted. 

I think most people wanted him caught.

[Noahfence]

How boring 

[Trumpet]

1 hour ago, Guesty said:

Not sure the cyclist thought this through when he brought the case. I never heard about this before (happened in Belgium). He brings a defamation case because the dad posted this video after he refused to apologise for kneeing his 5 year old as he rode past. The cyclist originally got off with a 1 euro fine because, apparently, the social media backlash was punishment enough for knocking over a 5 year old.

 

The cyclist has now won his defamation case against the dad for putting the recording on social media (which he only did originally asking for advice). Now it's going viral all over the world, instead of just Belgium, so many more people are watching him. I bet when cyclists saw this they just sighed and were like: it's people like you who give us a bad name. The cynical part of me suspects this cyclist is quite well connected; not sure a working class teenager would get this treatment.

Legal case aside, what kind of a dad records that without launching the cyclist into the trees on the left? 

[BKLFox]

52 minutes ago, Chelmofox said:

Didn't realise how bad Flintoff's facial injuries were.

 

https://www.bbc.co.uk/sport/cricket/66755339

Yep 1st thing I thought, if this is 9mths later he must have been a right mess and very lucky to still be here, no wonder it’s put the frighteners on him.

 

Can see Top Gear folding off the back of this,
No real loss as has been getting silly for a number of years now.

 

 

Edited 9 September 2023 by BKLFox

[Tuna]

12 minutes ago, Trumpet said:

Legal case aside, what kind of a dad records that without launching the cyclist into the trees on the left? 

One who didn't want to go to prison for assault?

[Trumpet]

4 minutes ago, Tuna said:

One who didn't want to go to prison for assault?

With any luck he’d have received a load of abuse online from angry cyclists meaning he’d avoid the jail term.

[Chelmofox]

1 minute ago, BKLFox said:

Yep 1st thing I thought, if this is 9mths later he must have been a right mess and very lucky to still be here, no wonder it’s put the frighteners on him.

 

Can see Top Gear folding off the back of this,
No real loss as has been getting silly for a number of years now.

James May had a nasty accident in one of the latest episodes of The Grand Tour doing 90 MPH is a tunnel. He was lucky not to be more severely injured but when i watched it I was surprised no-one from the crew was hurt.  The 2 shows have largely tried to out do each other in the adrenalin junkie stakes. Its a shame because I like the travel / adventure episodes and am less interested in all the dangerous tuff.

[Danizen]

1 hour ago, Innovindil said:

Genius really. 

 

Been trained in evasion techniques by the army. 

 

Escapes prison ninja style. 

 

Stays in one of the most cctv covered cities on the planet. 

 

Can't believe they caught him. 

He was probably trying to make his way to the Iranian Embassy. 

[Zear0]

6 hours ago, foxile5 said:

****ing massive earthquake in Marrakech.

 

I was there four weeks ago and none of the Medina is in any way earthquake proofed.

 

Think the death toll is going to be significant.

1k so far. Shudder to think how bad it'll get if that's less than 24 hours after the event. The CCTV is harrowing, whether it's the camera angle, building construction not as robust as Japanese buildings etc. but it's the worst one I've seen footage from. 

[foxile5]

1 hour ago, Zear0 said:

1k so far. Shudder to think how bad it'll get if that's less than 24 hours after the event. The CCTV is harrowing, whether it's the camera angle, building construction not as robust as Japanese buildings etc. but it's the worst one I've seen footage from. 

The Medina is home to so many and it's essentially wattle and daub style - very dry bricks and mortar that have stood for such a long time.

 

It's just about the most unsuitable type of place for an earthquake I've ever been.

 

Harrowing.

[dsr-burnley]

12 hours ago, Sideshow Faes said:

Since its creation, NHS spending has increased by an average of 3.7 per cent per year in real terms. But from 2010/11 to 2018/19, NHS funding growth slowed to 1.4 per cent per year (I misquoted 1.8%).

 

The change in these years was from £130.2bn to £148.4bn. An £18bn rise across 9 years is approx 1.4% per year compounded (not bothered to calculate but it's certainly in that ballpark and given 1.4% is cited by several sources such as the NHS confederation I've no reason to waste my time calculating when I can see with my own eyes it's close).

 

From the end of 2019/20 figures are affected by covid.

 

Blue columns I think is predicted spend.

It should be noted that current NHS spend on care is also being significantly affected by energy prices, staff pay increases not being fully covered by central spend increases, general inflation and ongoing costs due to COVID. The NHS federation has an article here that discusses this (my first paragraph about the 1.4% is directly lifted from this article) https://www.nhsconfed.org/articles/is-nhs-awash-with-cash .

 

You should also be aware that twice during this whole period the NHS has not only delivered it's services, but has undergone full scale reorganisations, with all the associated costs they involve.

 

Thanks, now I understand why your figures and my figures were so different.  When you quoted NHS spending going up by 1.8% and population up by 7%, I thought you were comparing like with like and saying how slow spending growth is compared with population size.  I didn't realise that one figure was annual and the other was a ten-year total.  Without that clarification, the numbers are meaningless.

 

I believe what you were actually saying is that NHS spending is going up by a percentage point and more faster than the population, but the changing population demographic means that isn't enough.  Is that right? 

[Guesty]

 

[Guest Sideshow Faes]

2 hours ago, dsr-burnley said:

Thanks, now I understand why your figures and my figures were so different.  When you quoted NHS spending going up by 1.8% and population up by 7%, I thought you were comparing like with like and saying how slow spending growth is compared with population size.  I didn't realise that one figure was annual and the other was a ten-year total.  Without that clarification, the numbers are meaningless.

 

I believe what you were actually saying is that NHS spending is going up by a percentage point and more faster than the population, but the changing population demographic means that isn't enough.  Is that right? 

Effectively yes. Demographics have a huge impact on health. Also, something not understood well enough in public debates around health is the fact that heath setting activity is only around 25% of what affects public health - which in turn feeds back into health care demand. So things like poverty, education, sporting opportunities - actually a really wide set of different things too long to list here - affect public health, and so the NHS after a decade of austerity not only has to deal with demographic changes that are making care more complex, more costly, longer - the population getting older, not only has to deal with the virtual collapse of other parts of the public health system - care homes, public health, social care, mental health - meaning capacity is problematic and patients can't be released to the right places, but also has to deal with the knock on effects of rising poverty such as poorer childhood health, rising obesity, substance abuse etc linked to desperation. You can't look at health in isolation, all parts of our public services are in crisis.

 

If you look at policing you could find ways to criticise spend Vs results there also if you look on a superficial level. But the reality is that there are huge challenges there too - we all know about the cuts to policing numbers in the first decade of austerity, but huge numbers of support staff went. Police are dealing with mental health more and more because mental health services are overwhelmed and in crisis, because the social fabric of the country have been torn about affecting the mental health of those that can no longer cope - whether that be the disabled forced to with in jobs they can't manage because of flawed ability to work tests, whether that be the lack of specialist schools for those with autism and learning difficulties etc - the police are overwhelmed with having to support poor mental health because those suffering have nowhere else to go. Then the criminal justice system itself has been allowed to fall to rack and ruin. Huge backlogs, reductions in legal aid support, the whole thing is a mess. 

 

My main point is that to look at a few graphs and decide that civil servants are to blame is hugely wrong. The government are to blame for the state of the nation, the good will of civil servants, police, health workers etc, who have been treated like crap for a decade is the only thing holding public services together at all.

 

When labour were in power, like them or loathe them, if somebody had asked you what the government's strategy was to improve education, you knew - the three Rs, to reduce inequality there was sure start, tax credits, increases to child benefit and a strategy to reduce poverty. In the NHS there was a clear strategy to invest. Across the board, satisfaction with public services increased, and hugely importantly the outcomes were genuinely positive. They actually achieved what they set out to.

 

Ask yourself this: what is the Tories strategy to improve anything? There isn't one. They want power simply to have power, with no idea of what to actually do with it (beyond enriching themselves).

[dsr-burnley]

31 minutes ago, Sideshow Faes said:

When labour were in power, like them or loathe them, if somebody had asked you what the government's strategy was to improve education, you knew - the three Rs, to reduce inequality there was sure start, tax credits, increases to child benefit and a strategy to reduce poverty. In the NHS there was a clear strategy to invest. Across the board, satisfaction with public services increased, and hugely importantly the outcomes were genuinely positive. They actually achieved what they set out to.

 

Ask yourself this: what is the Tories strategy to improve anything? There isn't one. They want power simply to have power, with no idea of what to actually do with it (beyond enriching themselves).

Broadly speaking I agree a lot of the first few paragraphs.  All the Tories can think of to do, apart from a few successes like phonics and academy schools, is spend more money.  And they find that spending more money doesn't help, largely because the money isn't going to the right place - the people doing the work.  However we got there, we have reached the utter nonsense of the Letby case whereby the doctors and consultants were not in charge of the hospital, the pen-pushers were, and the very good medical reasons why Letby should not have been allowed to go on killing babies were outweighed by people more concerned with reputation than babies.  If Labour made any useful promises, such as abolishing PHE and replacing it with an NHS organisation with health as its primary purpose, I would even vote for them.

 

I don't agree the first of the paragraphs I have quoted.  Labour achieved what they achieved, which I would say was more maintaining the status quo, by big tax rises.  (Tax rises which the Tories have since trumped, but that's another issue.)  Specifically, my biggest objection was the Gordon Brown excess of public-private partnership debt.  The only rationale for this was that if money is borrowed via PPI, the bedt does not count as part of the national debt because it is a finance lease, not a liability.  A commitment to pay £1bn per year on a loan is part of the national debt; a commitment to pay £1.2bn per year on a finance lease is not, so was to be preferred.  (The operating costs were not part of the debt either.  £60 to change a light bulb.)

 

I agree the last paragraph.  Starmer's policy in opposition is to say as little as possible and to promise as little as possible, relying on an election campaign of "not being Conservative".  Sunak is operating the policy of say as little as possible and do as little as possible and rely on an election campaign of "not being Labour".  He is hopeless.

[Guest Sideshow Faes]

10 hours ago, dsr-burnley said:

Broadly speaking I agree a lot of the first few paragraphs.  All the Tories can think of to do, apart from a few successes like phonics and academy schools, is spend more money.  And they find that spending more money doesn't help, largely because the money isn't going to the right place - the people doing the work.  However we got there, we have reached the utter nonsense of the Letby case whereby the doctors and consultants were not in charge of the hospital, the pen-pushers were, and the very good medical reasons why Letby should not have been allowed to go on killing babies were outweighed by people more concerned with reputation than babies.  If Labour made any useful promises, such as abolishing PHE and replacing it with an NHS organisation with health as its primary purpose, I would even vote for them.

 

I don't agree the first of the paragraphs I have quoted.  Labour achieved what they achieved, which I would say was more maintaining the status quo, by big tax rises.  (Tax rises which the Tories have since trumped, but that's another issue.)  Specifically, my biggest objection was the Gordon Brown excess of public-private partnership debt.  The only rationale for this was that if money is borrowed via PPI, the bedt does not count as part of the national debt because it is a finance lease, not a liability.  A commitment to pay £1bn per year on a loan is part of the national debt; a commitment to pay £1.2bn per year on a finance lease is not, so was to be preferred.  (The operating costs were not part of the debt either.  £60 to change a light bulb.)

 

I agree the last paragraph.  Starmer's policy in opposition is to say as little as possible and to promise as little as possible, relying on an election campaign of "not being Conservative".  Sunak is operating the policy of say as little as possible and do as little as possible and rely on an election campaign of "not being Labour".  He is hopeless.

I disagree very strongly with your first paragraph. The Tories have not spent enough. There have been huge cuts across the board to allow the health service and other public sector bodies to keep delivering core services. Everything else has seen cuts. No disrespect, you can probably guess I'm a public sector worker, but I'm fortunate in my role to work across a lot of organisations and have a lot of access to senior decision makers. The idea there is enough money in systems is so far off being correct it's almost unbelievable. Again, looking from afar with a few graphs is not a way to get to the truth.

 

Agree re labour's use of PPI - realistically it was done to stop the Tories moaning that national debt was increasing to fund the rebuilding of hospitals. In reality, national debt absolutely should have been used to rebuild hospitals. 

 

When it comes to operating costs (£60 to change a lightbulb as you claim) none of that falls under PPI and maintenance and service contracts, facilities and estates management are entirely separate things and, again, there are experts in place to consider contractual arrangements.

 

In reality, the UK has focused too much on the idea of pretend competition - constantly a Tory ideal for reasons that have never actually worked in reality - when what we need to see is sufficient funding of public services to allow collaboration between different parts to produce better results - NHS working with councils and other gov depts to offer things that together would have genuine benefits to the population - the pretence that questions around free school meals, the selling off of playing fields, the lack of emphasis on PE, cuts to benefits and increasing sanctions, don't have health impacts is ludicrous. In countries where public services deliver better results and populations are happier, public services are better funded and are collaborative in their strategic thinking. 

Edited 10 September 2023 by Sideshow Faes

[urban.spaceman]

4 hours ago, Guesty said:

 

"Most Tory researchers are not Chinese spies"

[dsr-burnley]

27 minutes ago, Sideshow Faes said:

I disagree very strongly with your first paragraph. The Tories have not spent enough. There have been huge cuts across the board to allow the health service and other public sector bodies to keep delivering core services. Everything else has seen cuts. No disrespect, you can probably guess I'm a public sector worker, but I'm fortunate in my role to work across a lot of organisations and have a lot of access to senior decision makers. The idea there is enough money in systems is so far off being correct it's almost unbelievable. Again, looking from afar with a few graphs is not a way to get to the truth.

 

Agree re labour's use of PPI - realistically it was done to stop the Tories moaning that national debt was increasing to fund the rebuilding of hospitals. In reality, national debt absolutely should have been used to rebuild hospitals. 

 

When it comes to operating costs (£60 to change a lightbulb as you claim) none of that falls under PPI and maintenance and service contracts, facilities and estates management are entirely separate things and, again, there are experts in place to consider contractual arrangements.

 

I'm not really sure why you're mixing up public health England and the NHS. They have an inter-relationship but there's no specific reason why PHE being dissolved and reconstituted as an NHS body would be helpful. I'd suggest it would likely be unhelpful to health outcomes. Can you explain why you think differently?

 

In reality, the UK has focused too much on the idea of pretend competition - constantly a Tory ideal for reasons that have never actually worked in reality - when what we need to see is sufficient funding of public services to allow collaboration between different parts to produce better results - NHS working with councils and other gov depts to offer things that together would have genuine benefits to the population - the pretence that questions around free school meals, the selling off of playing fields, the lack of emphasis on PE, cuts to benefits and increasing sanctions, don't have health impacts is ludicrous. In countries where public services deliver better results and populations are happier, public services are better funded and are collaborative in their strategic thinking. 

The PHE question one I can answer easily.  The NHS ought to be under the direct control of the minister, not a semi-autonomous body that the minister has limited control over.  The state of the government and civil service being what it is, means it won't necessarily be better; but it has a chance.

 

I don't doubt that a lot of necessary work isn't being done because the money isn't available.  But what's the government to do?  They are spending more than ever.  There may be a disconnect between the money going out of the taxpayer's pockets to the money going into essential services, but if the former is going up and the latter going down, it is no solution to make the first number higher and yet higher.  It's the gap in the middle that needs addressing. 

 

The NHS has a proud boast that 52% of their staff have some medical qualification.  What are the other 48% doing?  Bearing in mind that cleaning and caretaking and catering services and the like are almost always contracted out, so those people aren't part of the 48%, what are the 48% doing?  Couldn't they be replaced with medics?

 

Or the consultant whose letter was published in the Daily Telegraph a few weeks back, who operates as few as one day a fortnight.  He has colleagues in the USA who are operating three or four days a week, for the tawdry reason that that's how the hospital makes money, but it would be equally valid if that system was put in place because that is how surgeons heal the sick.  The system ought to be set up so that the surgeon is king (or queen) and all arrangements are made so that the surgeon can do his (or her) job.

 

At least some of the PPI deals in hospitals, probably most of them, had the maintenance contract linked with the deal.  And as a matter of principle, the experts who agreed the £60 to change a light bulb (actually a fluorescent tube, for accuracy) can easily be dispensed with.  You don't need to pay an expert's wage to find a way of changing a bulb cheaper than that.

[Guest Sideshow Faes]

Just now, dsr-burnley said:

The PHE question one I can answer easily.  The NHS ought to be under the direct control of the minister, not a semi-autonomous body that the minister has limited control over.  The state of the government and civil service being what it is, means it won't necessarily be better; but it has a chance.

 

I don't doubt that a lot of necessary work isn't being done because the money isn't available.  But what's the government to do?  They are spending more than ever.  There may be a disconnect between the money going out of the taxpayer's pockets to the money going into essential services, but if the former is going up and the latter going down, it is no solution to make the first number higher and yet higher.  It's the gap in the middle that needs addressing. 

 

The NHS has a proud boast that 52% of their staff have some medical qualification.  What are the other 48% doing?  Bearing in mind that cleaning and caretaking and catering services and the like are almost always contracted out, so those people aren't part of the 48%, what are the 48% doing?  Couldn't they be replaced with medics?

 

Or the consultant whose letter was published in the Daily Telegraph a few weeks back, who operates as few as one day a fortnight.  He has colleagues in the USA who are operating three or four days a week, for the tawdry reason that that's how the hospital makes money, but it would be equally valid if that system was put in place because that is how surgeons heal the sick.  The system ought to be set up so that the surgeon is king (or queen) and all arrangements are made so that the surgeon can do his (or her) job.

 

At least some of the PPI deals in hospitals, probably most of them, had the maintenance contract linked with the deal.  And as a matter of principle, the experts who agreed the £60 to change a light bulb (actually a fluorescent tube, for accuracy) can easily be dispensed with.  You don't need to pay an expert's wage to find a way of changing a bulb cheaper than that.

Okay so you don't mean PHE (which no longer exists and is a body under the control of the SofS), you mean NHS England. Why would you want to see the NHS in England under the control of a politician rather than experts? Just a question, it was obviously a Tory government that introduced NHSE as part of the disastrous Langsley reforms under David Cameron. The reason they wanted NHSE to not be under SofS control is to try to renounce blame when austerity bit and the NHS could no longer deliver. 

 

What is a government to do? Spend according to demand rather than according to utterly arbitrary economic rules that it sets itself.

 

What are the staff doing? Not sure about your %s but let's say you've got them right - firstly there will be HCAs who don't have formal nurse or Dr training but who do significant amounts of work. Not knowing where your numbers come from, I can't look to see if allied health professionals are included or not (front line medical staff).

 

Beyond that, they are doing procurement, finance, HR, payroll, risk management, governance, fraud prevention, security management, emergency planning, learning and development.....the list goes on. Basically, all the things every large organisation does. And also all the things that are legislated for by the government. Then there are regulatory bodies that cover clinical quality and medicines, NHS digital and NHSX that deal with cyber threats and IT, Health Education England that deals with, well, education of clinical staff....I could go on and on. 

 

The NHS has over 1.3 million staff, a budget of over £140bn, a huge number of risks in all sorts of ways. The pretence it could be (or it would even be a good thing to be) run by clinical staff is just another right wing nonsense talking point. 

 

As for consultants, they are treated like Gods. Not giving consultants enough is absolutely not the problem.

[dsr-burnley]

38 minutes ago, Sideshow Faes said:

Okay so you don't mean PHE (which no longer exists and is a body under the control of the SofS), you mean NHS England. Why would you want to see the NHS in England under the control of a politician rather than experts? Just a question, it was obviously a Tory government that introduced NHSE as part of the disastrous Langsley reforms under David Cameron. The reason they wanted NHSE to not be under SofS control is to try to renounce blame when austerity bit and the NHS could no longer deliver. 

 

What is a government to do? Spend according to demand rather than according to utterly arbitrary economic rules that it sets itself.

 

What are the staff doing? Not sure about your %s but let's say you've got them right - firstly there will be HCAs who don't have formal nurse or Dr training but who do significant amounts of work. Not knowing where your numbers come from, I can't look to see if allied health professionals are included or not (front line medical staff).

 

Beyond that, they are doing procurement, finance, HR, payroll, risk management, governance, fraud prevention, security management, emergency planning, learning and development.....the list goes on. Basically, all the things every large organisation does. And also all the things that are legislated for by the government. Then there are regulatory bodies that cover clinical quality and medicines, NHS digital and NHSX that deal with cyber threats and IT, Health Education England that deals with, well, education of clinical staff....I could go on and on. 

 

The NHS has over 1.3 million staff, a budget of over £140bn, a huge number of risks in all sorts of ways. The pretence it could be (or it would even be a good thing to be) run by clinical staff is just another right wing nonsense talking point. 

 

As for consultants, they are treated like Gods. Not giving consultants enough is absolutely not the problem.

Why would I want the NHS administrative body to be democratically accountable rather than a law unto itself?  I think they way I framed the question makes the answer obvious.

 

The 48% non-medical staff comes from the NHS annual report.  It seems an awful lot of admin staff.  Every large organisation has an admin staff, but few of them have 48% of their workforce doing it.  And you misunderstand my comment about the medical staff running it.  I don't say that the doctors should be paying the bills and designing the buildings, I say that the medical staff as a whole ought to be top of the tree and the admin staff should be there to do what the medics need.  At present the ethos seems to me to be that the admin staff set the parameters and the medics have to fit round them.

 

For example, Blackburn hospital (which some years ago had an abysmal record for cancelled appointments, and I don't know if it's improved since - anecdotally suggests not) worked on the basis of 4 operating theatres needed 4 surgeons and 4 anaesthetists and 4 of everything else.  So if the light bulb needed replacing, the surgeon and anaesthetist and the rest had nothing to do.  It's waste.  The whole idea that hospitals should be run at maximum capacity (not just a Tory idea, either) is largely responsible for this mess of waiting lists and the rest, and was already responsible before covid - they deliberately set up the system so there is no spare capacity for a crisis, and then get surprised when a crisis means they can't cope.

[Guest Sideshow Faes]

2 minutes ago, dsr-burnley said:

Why would I want the NHS administrative body to be democratically accountable rather than a law unto itself?  I think they way I framed the question makes the answer obvious.

 

The 48% non-medical staff comes from the NHS annual report.  It seems an awful lot of admin staff.  Every large organisation has an admin staff, but few of them have 48% of their workforce doing it.  And you misunderstand my comment about the medical staff running it.  I don't say that the doctors should be paying the bills and designing the buildings, I say that the medical staff as a whole ought to be top of the tree and the admin staff should be there to do what the medics need.  At present the ethos seems to me to be that the admin staff set the parameters and the medics have to fit round them.

 

For example, Blackburn hospital (which some years ago had an abysmal record for cancelled appointments, and I don't know if it's improved since - anecdotally suggests not) worked on the basis of 4 operating theatres needed 4 surgeons and 4 anaesthetists and 4 of everything else.  So if the light bulb needed replacing, the surgeon and anaesthetist and the rest had nothing to do.  It's waste.  The whole idea that hospitals should be run at maximum capacity (not just a Tory idea, either) is largely responsible for this mess of waiting lists and the rest, and was already responsible before covid - they deliberately set up the system so there is no spare capacity for a crisis, and then get surprised when a crisis means they can't cope.

So let's focus on one thing at once. The 48%. 

 

I'm asking you two questions about this number - one based on where it came from to understand what information you consume. The other assuming it to be true (yet to see exactly what that truth actually means even then), about what you think doesn't need to be done.

 

So:

 

1- you say the 48% can't from the NHS annual report. I've no idea what report you're talking about. There's isn't an NHS annual report. Do you mean the NHSE annual report? What page? Where have you read the number yourself - I'm assuming another source that tells you it's in an annual report you can't correctly identify? I can live with the fact you might not know the exact NHS body as the NHS is pretty gargantuan but I'm wondering what it is you read that's pointed this out - just to understand where you're coming from.

 

2- exactly what do you think the NHS shouldn't do? Which of these areas involving non-clinical staff is dispensible? HR, finance, procurement, risk management, governance, fraud prevention, security management, learning and development, IT/cyber/digital, medicines management (considers drug costs and works with prescribers to reduce overall spend), NHS resolution (provides insurance to NHS trusts through risk sharing), NHS property services, medicines regulators, clinical quality regulators, financial regulators...... What is it you think isn't needed?

[Guest Sideshow Faes]

19 minutes ago, dsr-burnley said:

Why would I want the NHS administrative body to be democratically accountable rather than a law unto itself?  I think they way I framed the question makes the answer obvious.

 

The 48% non-medical staff comes from the NHS annual report.  It seems an awful lot of admin staff.  Every large organisation has an admin staff, but few of them have 48% of their workforce doing it.  And you misunderstand my comment about the medical staff running it.  I don't say that the doctors should be paying the bills and designing the buildings, I say that the medical staff as a whole ought to be top of the tree and the admin staff should be there to do what the medics need.  At present the ethos seems to me to be that the admin staff set the parameters and the medics have to fit round them.

 

For example, Blackburn hospital (which some years ago had an abysmal record for cancelled appointments, and I don't know if it's improved since - anecdotally suggests not) worked on the basis of 4 operating theatres needed 4 surgeons and 4 anaesthetists and 4 of everything else.  So if the light bulb needed replacing, the surgeon and anaesthetist and the rest had nothing to do.  It's waste.  The whole idea that hospitals should be run at maximum capacity (not just a Tory idea, either) is largely responsible for this mess of waiting lists and the rest, and was already responsible before covid - they deliberately set up the system so there is no spare capacity for a crisis, and then get surprised when a crisis means they can't cope.

Separately, I'd point out that clinicians manage clinicians. Where have you got the idea clinicians aren't too of the tree? You cited the recent case involving child deaths. Every part of the management chain would have involved clinicians - do you seriously think finance or risk staff would get involved? There'd be clinical management within the unit, there'd be a patient safety team, there'd be a safeguarding team, there'd be a clinical quality committee.... Everybody involved would be clinically trained and expert.

[dsr-burnley]

30 minutes ago, Sideshow Faes said:

So let's focus on one thing at once. The 48%. 

 

I'm asking you two questions about this number - one based on where it came from to understand what information you consume. The other assuming it to be true (yet to see exactly what that truth actually means even then), about what you think doesn't need to be done.

 

So:

 

1- you say the 48% can't from the NHS annual report. I've no idea what report you're talking about. There's isn't an NHS annual report. Do you mean the NHSE annual report? What page? Where have you read the number yourself - I'm assuming another source that tells you it's in an annual report you can't correctly identify? I can live with the fact you might not know the exact NHS body as the NHS is pretty gargantuan but I'm wondering what it is you read that's pointed this out - just to understand where you're coming from.

 

2- exactly what do you think the NHS shouldn't do? Which of these areas involving non-clinical staff is dispensible? HR, finance, procurement, risk management, governance, fraud prevention, security management, learning and development, IT/cyber/digital, medicines management (considers drug costs and works with prescribers to reduce overall spend), NHS resolution (provides insurance to NHS trusts through risk sharing), NHS property services, medicines regulators, clinical quality regulators, financial regulators...... What is it you think isn't needed?

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/january-2022#:~:text=Professionally qualified clinical staff make,645%2C309 FTE in January 2022.

 

I've seen the 52% on a more detailed financial report as well.

 

As for the list of staff, if you tell me that every single person employed in every single department is indispensable, then I don't have information to contradict you.  I don't, however, recall any post suggesting that entire departments need to be closed as the only was of cutting staff.  I can't see where you got that impression from.

 

There is still the broad brush, top level, question.  If money going into the system is increasing (which it is) and the money spent at the business end is decreasing (which it appears to be), then there is a black hole somewhere.  It need plugging.

 

 

[dsr-burnley]

25 minutes ago, Sideshow Faes said:

Separately, I'd point out that clinicians manage clinicians. Where have you got the idea clinicians aren't too of the tree? You cited the recent case involving child deaths. Every part of the management chain would have involved clinicians - do you seriously think finance or risk staff would get involved? There'd be clinical management within the unit, there'd be a patient safety team, there'd be a safeguarding team, there'd be a clinical quality committee.... Everybody involved would be clinically trained and expert.

Senior management reinstated Letby onto the maternity ward after she was suspended at the insistence of the doctors.  Were those "senior management" people all practising doctors and other medical staff?