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Whistle in the Wind

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1Whistle in the Wind Empty Whistle in the Wind Mon Jan 10, 2022 8:32 am

Ten Bobsworth


El Hadji Diouf
El Hadji Diouf

Peter Duffy's NHS horror story, 'Whistle in the Wind', arrived from Amazon yesterday afternoon along with Peter's most recent book 'Smoke and Mirrors'.

After dinner I settled down to make a start on the first. I hadn't intended to read the whole horrifying story in a single session but it was unputdownable. The story, sadly, is all too believable to anyone with experience of sounding the alarm in the NHS.

2Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 12:01 pm

wanderlust

wanderlust
Nat Lofthouse
Nat Lofthouse

Ten Bobsworth wrote:Peter Duffy's NHS horror story, 'Whistle in the Wind', arrived from Amazon yesterday afternoon along with Peter's most recent book 'Smoke and Mirrors'.

After dinner I settled down to make a start on the first. I hadn't intended to read the whole horrifying story in a single session but it was unputdownable. The story, sadly, is all too believable to anyone with experience of sounding the alarm in the NHS.
The NHS and Community Care Act was one of the last kicks in the balls Thatcher's government gave the nation and the irony of introducing NHS Trusts - allegedly in the name of efficiency - was that it simply served to shoehorn in layers of unproductive profit-driven "management" and the additional associated costs.

It was intended to decentralise the national responsibility for care for all and put the burden on to Local Authorities whilst at the same time carving out the Health Authorities from the LAs - so that Local Authorities carried the burden of responsibility of provision and had to pay the bills - but could no longer directly manage the services they were required to provide - having to procure them externally instead. Absolute madness.

3Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 12:58 pm

Sluffy

Sluffy
Admin

wanderlust wrote:It was intended to decentralise the national responsibility for care for all and put the burden on to Local Authorities whilst at the same time carving out the Health Authorities from the LAs - so that Local Authorities carried the burden of responsibility of provision and had to pay the bills - but could no longer directly manage the services they were required to provide - having to procure them externally instead. Absolute madness.

Eh???

You've misunderstood the concept entirely!

What happened (and I'm talking in general at not just about the health service) was a form of denationalisation, if you will and a move to a 'client' and 'contractor' split instead.

In the past local authorities traditionally ran services from top to bottom, from planning and managing services to employing staff and carrying them out - think for instance of how councils used to employ their own refuse collection services or use to have their own 'direct works' services (which employed tradesman to build and maintain council houses, etc) now instead most councils simply put refuse services out to tender and Hosing Associations now provide social housing, leaving local authorities with significantly less direct costs of providing the labour themselves and buying services at considerably less costs that they can achieve themselves, whilst still discharging the legal responsibility for those services through the councils 'client' service functions.

The same concept if you will happened to denationalise British Rail, British Gas, The Electricity Boards, etc.

Whether you agree with the concept is another thing but the client/contractor split is how business works, most companies contractually 'buy' in services when they are cheaper than employing and training staff directly themselves.

I mean who wouldn't do that if they could - and up to the Thatcher government brining in such powers, councils (and the nationalised industries) couldn't or politically wouldn't!

I would have thought you would be one of those greatly in favour of this change considering you have told us on here that your wife's business model is providing exactly that form of service to your local building companies - they being the 'client' your wife's business being the 'contractor'!

4Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 1:48 pm

wanderlust

wanderlust
Nat Lofthouse
Nat Lofthouse

Yup -it was similar to denationalisation and yes it moved national services into the private sector and yes there was a fair few staff TUPEd (or whatever it's predecessor was called) from LAs to Trusts but the issues created were structural and unique to healthcare.

If you look at denationalising British Rail for example (which incidentally the current government is starting to renationalise!) the private companies contracted inherited the infrastructure, rolling stock and the staff (at a bargain basement price) so their focus and cost base was predominantly planned maintenance and replacement with a slowly expanding customer base.
The NHS costs however were focused on high tariff consumables (drugs) staff and what is effectively rent since the introduction of PFI by Major in 92. The NHS immediately lost it's large scale buying power - although this has more recently been partially replaced with private sector buyer groups - against a backdrop of rocketing drug prices and rapidly expanding customer base leaving it at the mercy of central government funding and private sector profiteering - which IMO is directly contradictory to the principles on which is was established and the principles that Britons of all political shades hold up to the rest of the world as being an example of societal inclusivity and national pride.

I have no problem with denationalisation where appropriate (and by that I mean where it makes sense to do so) but in the case of the NHS it made no economic sense and was in direct conflict with it's USP.

Point is that the NHS was kneecapped. Fine if society wishes to replace the NHS with a multiple tier health insurance scheme as per the USA but there is no overt political will to do that (although I've no doubt that some Tories, the private insurance sector and the Yanks in particular would love it)

We are left with a situation where the NHS is in desperate trouble and there is currently no palatable alternative - and a buyout of PFI and Trusts to renationalise is financially unconscionable.

Business is business but the NHS - like the Police force or the Army - wasn't created to be a business. Rail travel not so much.

5Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 3:03 pm

Sluffy

Sluffy
Admin

wanderlust wrote:Yup -it was similar to denationalisation and yes it moved national services into the private sector and yes there was a fair few staff TUPEd (or whatever it's predecessor was called) from LAs to Trusts but the issues created were structural and unique to healthcare.

If you look at denationalising British Rail for example (which incidentally the current government is starting to renationalise!) the private companies contracted inherited the infrastructure, rolling stock and the staff (at a bargain basement price) so their focus and cost base was predominantly planned maintenance and replacement with a slowly expanding customer base.
The NHS costs however were focused on high tariff consumables (drugs) staff and what is effectively rent since the introduction of PFI by Major in 92. The NHS immediately lost it's large scale buying power - although this has more recently been partially replaced with private sector buyer groups - against a backdrop of rocketing drug prices and rapidly expanding customer base leaving it at the mercy of central government funding and private sector profiteering - which IMO is directly contradictory to the principles on which is was established and the principles that Britons of all political shades hold up to the rest of the world as being an example of societal inclusivity and national pride.

I have no problem with denationalisation where appropriate (and by that I mean where it makes sense to do so) but in the case of the NHS it made no economic sense and was in direct conflict with it's USP.

Point is that the NHS was kneecapped. Fine if society wishes to replace the NHS with a multiple tier health insurance scheme as per the USA but there is no overt political will to do that (although I've no doubt that some Tories, the private insurance sector and the Yanks in particular would love it)

We are left with a situation where the NHS is in desperate trouble and there is currently no palatable alternative - and a buyout of PFI and Trusts to renationalise is financially unconscionable.

Business is business but the NHS - like the Police force or the Army - wasn't created to be a business. Rail travel not so much.

Well I've no knowledge and expertise in the Health authorities but I have extensive in local government public sector services and although 'care' and 'protection' services (you can add the armed forces in the same category as the police service) one of the ethos's of the public sector is 'effective and efficient' provision which has always included the economic costs of services and the prioritisation of needs from finite resourcing (funding).

As service requirements have increased over the years - growing population and rising crime - budgets have not - funding only coming from taxation (local or national).  People simply don't want to vote for higher taxation to pay for these needs.

Nationalised industries have always been seen to be financially inefficient and that has also been paralleled in traditional council service provision ie - refuse, homes for the elderly and other care provision services in the community, direct works (which include public highway and infra structure building). etc.

There's no question whether we like it or not that 'buying in' services rather than 'providing' services directly was cheaper - and can be clearly evidenced as to how many council in-house services failed to win their own contracts when submitted to compulsory competitive tendering.

Yes some companies deliberately tendered at a loss simply to win a share of the market (I would imagine this has happened in some of the rail franchises you obliquely reference to above in your post) but the bottom line is that all contracts are fixed term only and all have penalty clauses for failure to provide the contacted service awarded to them.

In respect of the NHS and police forces I expect they too have many services - particularly administrative and support services that can and have been put out to tender just has happened in the local council's.

At the end of the day the aim is to achieve the best value for money one is able to.

If the health service is as bad as you claim it to be following Thatcher's government reorganisation then why didn't the Labour government do something about them in their term of office between 1997 to 2010?

And need I remind you that it was under the Labour Administration that the PFI initiative really took off - they clearly thought that was the answer at the time!

I'm amazed that you are still wanting to fight battles that have been lost from twenty and thirty years or more ago - and even more surprised that you don't seemed to have understood the philosophy of why these things happened?

Your default setting clearly is hatred of everything the Tory party has done and ever will do.

You also seem to constantly bring into your reasoning that it is all a massive plot to allow America to 'buy and privatise' the NHS - without any reason to believe that is going to happen at all???

Certainly no party is ever going to win a general election in the near future with that on their manifesto.

6Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 3:31 pm

wanderlust

wanderlust
Nat Lofthouse
Nat Lofthouse

It's not a party issue - neither of the main parties have covered themselves in glory. I'm simply saying that what Thatcher did to the NHS was a mistake that was bad for the NHS and bad for the country. As was flogging off our oil and gas. The fact that Labour haven't done anything about it since is irrelevant because once you open Pandora's box there's no going back.

As for "nationalised industries have always been seen as inefficient" that's not true - that is a political concept that was only brought up in the 60s and it was well received as Brits like to have something to complain about - even when "we've never had it this good".

Nationalised industries can be crap but they can also be improved from within - every bit as much as they can be by privatisation - and I think we can agree that in France for example, SNCF and EdF (who are actually running part of our power network) are very efficient and successful state owned companies. As is the German national railway, Japan Airlines etc etc etc.

Also the French were much better at the process of privatising the appropriate state industries so that they had a better chance of maintaining the quality of service whilst being economically viable - think Renault cars (still 19% state owned) and Credit Lyonnais/SG in the banking sector.

The NHS should never have been treated like a business in the first place, but when it was it should have been handled very differently.

PS:

Last year alone (2021) Boris's government took state ownership of:

* The Atomic Weapons Agency (formerly AWE PLC FFS!)
* The Probation Service - it had been privatised in 2014
* Sheffield Forgemasters - now part of the MoD
* Southeastern railways

7Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 4:11 pm

Sluffy

Sluffy
Admin

wanderlust wrote:It's not a party issue - neither of the main parties have covered themselves in glory. I'm simply saying that what Thatcher did to the NHS was a mistake that was bad for the NHS and bad for the country. As was flogging off our oil and gas. The fact that Labour haven't done anything about it since is irrelevant because once you open Pandora's box there's no going back.

As for "nationalised industries have always been seen as inefficient" that's not true - that is a political concept that was only brought up in the 60s and it was well received as Brits like to have something to complain about - even when "we've never had it this good".

Nationalised industries can be crap but they can also be improved from within - every bit as much as they can be by privatisation - and I think we can agree that in France for example, SNCF and EdF (who are actually running part of our power network) are very efficient and successful state owned companies.

Also the French were much better at the process of privatising the appropriate state industries so that they had a better chance of maintaining the quality of service whilst being economically viable - think Renault cars (still 19% state owned) and Credit Lyonnais/SG in the banking sector.

The NHS should never have been treated like a business in the first place, but when it was it should have been handled very differently.

Rolling Eyes

If nationalised/state owned companies were cost efficient then all the countries in the western world would be running them.

Countries with national ideologies about stated owned central control - such as the USSR and China have moved away from that idea to privatisation - albeit they still have tentacles inside those companies.

Nationalised companies were highly inefficient - they were monopolies and had no competitors to challenge them on efficiencies and costs ffs!!!

You're stuck in 1960's/70's Labour party ideology - no wonder you have hatred of everything that's happened in the last forty/fifty years!

God knows how much it cost the French government to prop up their industries such as their rail and electricity companies over the years in order for them to be successful now, I expect billions must have been written off in underpinning them in order that they are what they are now.

And even if we take your view that everything Tory is shit, it won't change the last 40/50 years and there is absolutely no point crying over spilt milk - it's gone and nothing can change that.

What's the point as to keep whining and bitching on about 'could have, should have, would have' - it's too late that horse has bolted and long gone.

It's time for you to live for today and not keep harping back to what was going on in Harold Wilson and Ted Heath's days...!!!

Fat chance that is going to happen with you though.

8Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 5:17 pm

wanderlust

wanderlust
Nat Lofthouse
Nat Lofthouse

I clearly said that some state owned companies are efficient and some are not so why do you deliberately misread what I write in order to to argue?
I also stated that some state owned organisations are suitable for privatisation and some are not and that in my opinion the NHS was not - just like the Police and the military.

What is wrong with you? Quoting mistakes from the past doesn't mean I'm living there - you are the only person that is stuck - in your obsession with trying to start an argument with anyone who doesn't share your opinion even if it involves twisting what they are saying - and omitting the key points they make to do so. Grow up.

9Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 5:47 pm

Sluffy

Sluffy
Admin

wanderlust wrote:I clearly said that some state owned companies are efficient and some are not so why do you deliberately misread what I write in order to to argue?
I also stated that some state owned organisations are suitable for privatisation and some are not and that in my opinion the NHS was not - just like the Police and the military.

What is wrong with you? Quoting mistakes from the past doesn't mean I'm living there - you are the only person that is stuck - in your obsession with trying to start an argument with anyone who doesn't share your opinion even if it involves twisting what they are saying - and omitting the key points they make to do so. Grow up.

Hahaha!!!

Off you go again!

Look you decided to be selective in the examples you gave to try back up and validate what you were saying - I simply pointed that out and put the wider (and real world) picture instead.

You're the one whose been endlessly droning on about Thatcher and even Barbara Castle (ffs!) if that's not being stuck in the past I don't know what is!

And I have no need to 'twist' anything, I'm more than happy to stick with facts.

I'm certainly not the one who can't be seen to be ever wrong - and lie about it when found out...

...like you have eh Hoppy510!

Rolling Eyes

10Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 6:06 pm

Guest


Guest

But Sluffy, most topics do require specifics, this is just way too broad:

If nationalised/state owned companies were cost efficient then all the countries in the western world would be running them.

Both state owned and private companies can be efficient to the tax payer, in this country successive governments allowed privatisation to run riot - and it went too far, see the trains for example.

State owned companies are prominent across Western Europe, it's a nonsense to suggest they're only inefficient. You need to get away from over simplifying complex topics there are shades of grey.

11Whistle in the Wind Empty Re: Whistle in the Wind Mon Jan 10, 2022 10:28 pm

Sluffy

Sluffy
Admin

T.R.O.Y. wrote:But Sluffy, most topics do require specifics, this is just way too broad:

If nationalised/state owned companies were cost efficient then all the countries in the western world would be running them.

Both state owned and private companies can be efficient to the tax payer, in this country successive governments allowed privatisation to run riot - and it went too far, see the trains for example.

State owned companies are prominent across Western Europe, it's a nonsense to suggest they're only inefficient. You need to get away from over simplifying complex topics there are shades of grey.

Here knock yourself out on this YouGov survey from last year in which people from a number of country's were asked their views on what industries should be nationalised.

Not surprisingly to me at all are the more technically advanced country's such as Japan, USA, Canada, and Germany are those least wanting things nationalised and government controlled and even country's like France Spain and Italy seem to have little desire for it much either and are ALL shown below us in the final results.

Now which country is the one who least wants nationalisation, why that's us!

Well that is us if you take out Railways and energy companies - but even then France had a less desire for nationalised railways than we do and more or less the same feeling we do for energy at just under 20% of those surveyed!

So even the two particular examples Wanderlust used as his prime examples above to support nationalisation as success stories aren't even particularly greatly rated in their home country!

As for me over simplifying, you need to see the big picture if you want to see the woods and you can't do that by looking at one tree at a time.

K.I.S.S.

https://yougov.co.uk/topics/consumer/articles-reports/2021/02/25/global-survey-which-industries-should-be-nationali

13Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 2:44 am

Sluffy

Sluffy
Admin

Hahaha...

Really???

Mate apart from core government commercial functions like the British Business Bank - which is the means through which the government has provided all these billions worth of loans to keep companies afloat during Covid they are tiddlers mainly and several others of those you've listed have been taken into national holding simply to stop them collapsing (the banks and the railways) and will be sold off in due course - they haven't been renationalised in the county's interest at all as you seem to be suggesting!

You are so pathetic at times just trying to prove me wrong about something/anything!!!

You do so make me laugh though!



PS - Prestwick is in the process of bring sold!
https://www.bbc.co.uk/news/uk-scotland-56176018

14Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 6:39 am

Guest


Guest

You said state owned companies are inefficient, and to support that post a poll assessing the concept’s popularity? That makes no sense.

15Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 9:35 am

Ten Bobsworth


El Hadji Diouf
El Hadji Diouf

'Foundation trusts may have been an initiative of Labour under Tony Blair, but they were enthusiastically adopted by the coalition government in 2010. Andrew Lansley’s White Paper, Liberating the NHS, promised again to release NHS providers from central government micro-management and to increase foundation trusts’ freedoms to create the largest social enterprise sector in the world.


But in practice the model was under threat from its conception. Foundation trusts inhabited a precarious halfway house between the public and private sectors: independent corporations on paper yet entirely dependent on the state in reality – for funding, capital investment and bailouts when things went wrong (the original plan to create an independent NHS bank was discreetly abandoned)'

https://www.kingsfund.org.uk/blog/2016/02/foundation-trust-model

 I remember only too well the University Hospitals of Morecambe Bay NHS Trust (UHMBT), with the worst hospital related death rates in the entire country, being granted foundation trust status (in 2010 iirc). But that, my friends, is only the beginning.

If you read nothing else this year, you must read Peter Duffy's books, both of them. Available in paperback from Amazon for £13 the pair.

16Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 10:01 am

boltonbonce

boltonbonce
Nat Lofthouse
Nat Lofthouse

17Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 10:06 am

wanderlust

wanderlust
Nat Lofthouse
Nat Lofthouse

Ten Bobsworth wrote:'Foundation trusts may have been an initiative of Labour under Tony Blair,

Hardly "an initiative of Labour under Tony Blair" Bob.

NHS trusts were established under the National Health Service and Community Care Act 1990 and were set up in five waves. Each one was established by a statutory instrument and Foundation trusts were merely the latest such instrument.

The initiative was Thatcher's but it's no surprise Blair didn't - or moreover couldn't at that late stage - propose any radical reform of the system. Not that a closet Tory like Blair would even want to Smile

18Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 10:38 am

Ten Bobsworth


El Hadji Diouf
El Hadji Diouf

wanderlust wrote:
Hardly "an initiative of Labour under Tony Blair" Bob.

NHS trusts were established under the National Health Service and Community Care Act 1990 and were set up in five waves. Each one was established by a statutory instrument and Foundation trusts were merely the latest such instrument.

The initiative was Thatcher's but it's no surprise Blair didn't - or moreover couldn't at that late stage - propose any radical reform of the system. Not that a closet Tory like Blair would even want to Smile
So you are now a greater authority than the Kings Fund, are you?

UHMBT were being pushed towards foundation trust status under the previous Labour government, as was the notorious Mid-Staffs. The Secretary of State for Health and Monitor where both helping them despite the alarm bells that were ringing even then. It was a Labour Secretary of State that approved Mid-Staffs and a conservative, Andrew Lansley, that approved UHMBT as part of the coalition government with the Lib Dems.

The Labour government had also been pushing deals through with Virgin Health. Most of that was kept under wraps as was the fact that jet-lagged doctors with no knowledge of the NHS were being flown in to this neck of the woods from New York at immense cost to do weekend stints that NHS GPs were unwilling to do because of the deal agreed with them by the Blair administration.

19Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 1:51 pm

Ten Bobsworth


El Hadji Diouf
El Hadji Diouf

boltonbonce wrote:
Thanks for that, Boncey. It is mentioned in Whistle in the Wind.

I've now finished both books and I exhort you to do so  too. Whatever faults or failings your former employer may have had I guarantee that he did not come close to the faults and failings of Peter Duffy's employer, the NHS, or those who are supposed to regulate the way it is run.

20Whistle in the Wind Empty Re: Whistle in the Wind Tue Jan 11, 2022 1:57 pm

wanderlust

wanderlust
Nat Lofthouse
Nat Lofthouse

Ten Bobsworth wrote:
So you are now a greater authority than the Kings Fund, are you?
No Bob and if you'd care to read it properly you'd see that the King's Fund don't disagree with a single word I've written.

Or perhaps you in your wisdom could show me?

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