Sad consequence of rising costs

[SillyOldDufferModerator @sillyoldduffer]

Posted by RMA on 29/06/2022 08:14:04:

Posted by Jeff Dayman on 29/06/2022 01:31:18:

…

Referring to the NHS and the UK, if the management structure was pruned to an effective level and waste management implemented, they wouldn't have to resort to parking charges, or shopping franchises.

Sounds like Daily Mail thinking to me! Strong opinion, light on facts. But I expect RMA has the evidence to hand.

I'd just remark that simple solutions to complex problems are usually wrong. If fixing the NHS were as easy as pruning management and reducing waste, it would have been done years ago. Plenty of bright-eyed bushy-tailed politicians have taken charge of the NHS with similar notions and departed without achieving much: they don't last long! Problem is it's dead easy to generalise and much, much harder to come up with specific changes.

Thirty years ago, the government of the day introduced internal markets into the NHS. The idea was to unleash the forces that drive business efficiency in commerce. Unfortunately the NHS isn't a commercial entity, so setting up an internal market just introduced a mass of new admin requirements with little in return. Difficult to prove because no accounts were kept of internal market costs, itself a bad business failure, but it certainly didn't stop costs rising as before. Trouble with the idea is artificial competition created by politicians who never admit failure is nowhere near as effective as a real market.

We don't need simple answers. What's needed is strong accountability: quick enquiries, recommendations that are implemented, and no cover ups. NHS managers should be held to account by Ministers, Ministers should be held to account by the Cabinet, Cabinet should be held to account by their Party, the Party by Parliament, and MP's by the Electorate. The electorate are the weak link in the chain. Unfortunately too many vote uncritically on party principles and would rather be represented by a divisive incompetent wearing the right tie than an able performer from the other team, even temporarily.

My recipe for a better world: delivery should be run on engineering principles and politics of all flavours treated with suspicion. Too much emotion, prejudice, belief, opinion and self-interest in politics for comfort, We all know chaps convinced they should be running the country who can't be trusted to post a letter…

Dave

[Bob Unitt 1Participant @bobunitt1]

If you don't like hospital parking charges, come to Wales, we've had free hospital parking since 2018. The amount of space available varies from hospital to hospital, but you can usually find an empty slot.

The best 'hospital parking' story I know of was in an English hospital. They had a big rebuilding program, and put a helicopter landing pad on the roof of the new A&E, thereby freeing up a lot of ground-level space for parking. By the time they'd finished the rebuild, they'd bought a new helicopter. The new one was too heavy for the rooftop-pad (which had been designed without any weight allowance for a replacement copter), so they had to take the parking spaces back for a ground-level landing-pad.

As far as I'm aware no administrator, architect or building company was ever penalised for not allowing any slack for possible replacements in the design phase…

[JAParticipant @ja]

Since this topic has drifted into hospital parking charges I will have my say.

Recently I have been an outpatient at a small local hospital, one of a privately owned chain, that provides non-urgent operations for the NHS. It is located on an industrial estate and the parking is free. All you have to do is to give your car registration number to the receiptionist. This is totally different to the big Bristol NHS hospitals. It is either a policy of the owners or due to the local county council not charging for their town parking (I suspect it is both).

My understanding that efficiency in the NHS means no empty beds, that is no slack. If so this is, as seen, a recipe for problems.

JA

I am about to buy tickets for the Midlands Exhibition (next job).

Edited By JA on 29/06/2022 12:36:09

[martin perman 1Participant @martinperman1]

Can somebody tell me how to disconnect from this totally out of topic thread please.

Nobody reply please as I've just found how to do it. 

Martin P

Edited By martin perman on 29/06/2022 12:51:55

[HopperParticipant @hopper]

Posted by martin perman on 29/06/2022 12:49:48:

Can somebody tell me how to disconnect from this totally out of topic thread please.

Nobody reply please as I've just found how to do it.

Martin P

Edited By martin perman on 29/06/2022 12:51:55

The problem is people keep posting in it….

[Nigel Graham 2Participant @nigelgraham2]

It's not only going to be our and related hobbies that are going to be hit.

All manner of leisure activities use expensive kit (though that's usually occasional purchases and long-term use) and venues, meeting-places, etc. distant from many participants' homes. Those voluntary bodies running small museums, non-commercial arts and the like may well see fewer and fewer visitors to help pay for the increasing costs of maintaining the displays, despite the staff being unpaid. Some sports, and most outdoor-pursuits based on geographical features, enforce long trips on many of their participants.

This is before we think of "ordinary" holidays or visiting relatives living far from home.

Though as one of my caving friends, who also makes many round-trips for his other hobby of nature-photography, says though, "Do we want to moan about the fuel cost but carry on with our lives, or save the money by just sitting at home?"

'

More seriously for him and many other self-employed traders are the so-called "congestion charges" in some cities now, making them question the economics of taking on work in those places. They can absorb only so much before passing the fee to customers who can take only so much more and may not understand the concept of overheads. He is a Gas-Safe registered plumber and says he cannot now sensibly quote for major works for private homes, like replacing central-heating boilers; because the materials prices are rising too quickly. He found it hard enough estimating for that work in his own home, where the labour is free!

[Harry WilkesParticipant @harrywilkes58467]

Do i recall Mr Johnson saying he was going to stop hospital charging for parking or have I dreamed it up ? I do know my hospital as stopped charging blue badge holders for parking.

H

[Ian HewsonParticipant @ianhewson99641]

Just seen a flying 🐷

[Mike PooleParticipant @mikepoole82104]

It seems unreasonable to charge the sick who need to attend appointments at a hospital but is it right to charge visitors whose attendance probably has a positive effect on the patient being visited. The flip side is should the hospital spend money that could be spent on patients on a car park and the maintenance and management of it. contracting out parking to commercial concerns just fleeces the patients and visitors. I feel the ideal would be for those who wish to use a car to pay for the convenience of the facility but the facility operated by a not for profit organisation. Free parking is paid for by everyone from taxation and may have some merit if piling some more on our ever increasing burden is acceptable.

Mike

[Anonymous]

Posted by Mike Poole on 30/06/2022 18:42:34:

It seems unreasonable to charge the sick who need to attend appointments at a hospital

 

I have to go on a regular basis but I don't mind the parking charge per se (although I wouldn't mind it being a bit lower) if only there were adequate, quickly-accessible parking spaces available once I get into the parking …. having been dealt an entry ticket to get in which will have to be paid on exit (whether or not I actually find somewhere to park).

Edited By Peter Greene 🇨🇦 on 30/06/2022 19:01:41

[duncan webster 1Participant @duncanwebster1]

Posted by JA on 29/06/2022 12:32:37:

…….

Recently I have been an outpatient at a small local hospital, one of a privately owned chain, that provides non-urgent operations for the NHS. It is located on an industrial estate and the parking is free. All you have to do is to give your car registration number to the receiptionist………

That's what happens at one of our local NHS hospitals, but not all.

[Ady1Participant @ady1]

The main driver of Hospital issues is Mr Blairs PFI splurge which was dodgy government accounting that became a massive taxpayer fraud

There's been a lot of covering up by the system and establishment

put simply

Instead of buying your hospital with a 2% government loan you bought your hospital with a private sector credit card which didn't show up as government debt in their accounts

but this saddled the taxpayer with huge credit card cash payments each year

The first big tranche of PFI contract expiry events is happening over the next 5-10 years and could make the situation even worse if its not dealt with properly

For every £100 they borrowed our government geniuses are paying back more than £500y

Edited By Ady1 on 01/07/2022 09:21:05

[john fletcher 1Participant @johnfletcher1]

Why not use the bus when visiting the hospital, I'd rather spend the money on helping the sick than on car parking. Maybe the price rise of petrol will sort things out.

[SillyOldDufferModerator @sillyoldduffer]

Posted by Ady1 on 01/07/2022 09:03:08:

The main driver of Hospital issues is Mr Blairs PFI splurge which was dodgy government accounting that became a massive taxpayer fraud

There's been a lot of covering up by the system and establishment

…

Can't disagree with Ady other than to point out PFI and PPP have been badly misused by both Labour and Conservative governments. Equally guilty, and neither has been held to account!

PFI was introduced by a Conservative government (PM Major) and much extended by Labour (PM Blair). The Labour government was much criticised for PFI spending by the Conservative opposition, accurately and correctly in my opinion. Unfortunately, despite knowing PFI was a serious waste of taxpayers money the Conservatives chose to carry on with PFI after they took power in 2010.

Something over £300bn borrowed at triple market rate or worse. Government borrowing was tightly controlled by UK and EU law, but if you wanted to get things done, PFI bypassed the rules. The advantage to the politicians was it enabled them to keep their supporters happy by spending more money on them. The left got more spending on public services, the right got tax cuts. Tax cuts and better public services are both good in their way, but not when funded by borrowing money at well over normal rates.

Dave

[Nigel Graham 2Participant @nigelgraham2]

Ummmm, are we getting just a little "political" here?

I had to visit Dorset County Hospital, on two consecutive days, several years ago, for a heart-monitoring test. On Tuesday the hospital's P-&-D car-park was full, and I had to park a good quarter of a mile away in a housing-estate (but well away from homes).

Mentioning this to a nurse, she replied, "It's even worse on Wednesdays because that's Dorchester Market day and we get a lot of people using our car-park for that!"

I heeded her advice, so next day drove only part-way to Dorchester, to where I could readily park for free and complete the journey by a regular bus service that stops outside the hospital.

They are now building the hospital a multi-storey car-park with the twin advantages of being both architectural "carbuncle" (as Prince Charles might call it when visiting his "Poundbury" pseudo-village about a mile away) and more parking for the market bargain-seekers.

[Author]

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