Jacob
What goes around comes around.
Democracy - we are Peter AND Paul. What goes around comes around.Harry 48":1tury2kh said:
Should fiscal policy be independent of who is in office?
- Thread starter flanajb
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The broadcasters are not independent they are by and large just an extension of the establishment lots of things have gone unreported recently because it suits the Politicians/broadcasters to ignore it.The coverage of the Scottish referendum was a disgrace especially the BBC reporting the bias was unbelieveble.No doubt the general election will not be any better there is a lot reported on the RT channel omitted from our mainstream broadcasters
Cheshirechappie
Established Member
"I accept that most would not know the answers but is that the BBC fault? Or is life just so comfortable that people don't have to be bothered.
If you go to US and listen to Fox News you see a comparison to the BBC. You would have to be brain dead to accept what Fox News says as correct - blatantly biased towards the Republicans to the exclusion of fact or truth at times."
I think it is partly the BBC's (and other broadcasters') fault. At least in the BBC's case, it is supposed to be a public service, funded through a legally-enforceable licence fee. It has a Charter duty to Inform and Educate, not just Entertain.
Therein lies the difference with Fox News (and CNN). Not being funded by public money in any form, they are free to broadcast as they see fit, and anybody can choose which they pay for. Inevitably, they play to their respective audiences, just as the newspapers do in both the USA and the UK.
My point was a wider one encompassing UK broadcasters generally, not just the BBC. All of them fail to report politics in any breadth or depth, preferring the soundbite, the contrived argument, and political trivia.
If you go to US and listen to Fox News you see a comparison to the BBC. You would have to be brain dead to accept what Fox News says as correct - blatantly biased towards the Republicans to the exclusion of fact or truth at times."
I think it is partly the BBC's (and other broadcasters') fault. At least in the BBC's case, it is supposed to be a public service, funded through a legally-enforceable licence fee. It has a Charter duty to Inform and Educate, not just Entertain.
Therein lies the difference with Fox News (and CNN). Not being funded by public money in any form, they are free to broadcast as they see fit, and anybody can choose which they pay for. Inevitably, they play to their respective audiences, just as the newspapers do in both the USA and the UK.
My point was a wider one encompassing UK broadcasters generally, not just the BBC. All of them fail to report politics in any breadth or depth, preferring the soundbite, the contrived argument, and political trivia.
Jacob
What goes around comes around.
Whilst we're allowed :roll: political themes http://beezlystreet.com/2015/03/22/atos ... -for-work/
finneyb
Established Member
Very good Jacob
Jacob
What goes around comes around.
Random Orbital Bob
Established Member
That is a pretty harrowing story and no mistake. But folks have to be rational about this and using a near death to your baby scenario to illustrate health economics is hardly a stable place for a level headed discussion is it!
When I was still in software, the project management company I ran had quite a strong base in pharmaceuticals. Clients included GSK and notably Pfizer. The latter spent circa $50 Million on a combination of our software and consulting to implement it and the reason was they wanted to reduce their time and cost to market of any given block buster drug. Because of FDA and our equivalent safety regulations, the cost to get a significant new drug through clinical trials with all the R&D can be up to $500M. Combine that with the time limit on patent laws and you start to develop an understanding why the drug firms want to claw back their R&D investment. Of course they make substantial profits but look at the increase in health outcomes we've all enjoyed over the last 50 years. Staggering improvements in all areas including the big ones like cancer and heart disease. The fact is that whether peoples personal politics agree or disagree with it, a market economy coupled with our superb NHS is a business model that has improved clinical outcomes at a staggering rate. So much so that now we cant afford as a country to pay for their extra longevity. The model is so successful its driven the pension crisis.
It's also true that "some" procedures are better done in the private sector. Simple, repeatable, non chronic procedures can easily be handled by the private sector more efficiently than the NHS. Where the NHS scores really highly is in complex, chronic, multi-faceted diseases. Exactly like the kind my family has been through recently. Cancer being one and a rare bone disease requiring a specialist orthopaedic hospital the other. Take my sons case, his bone disease is so rare there are only about 300 cases in the country. He needed a specialist, research, teaching hospital where the decision making is at the cutting edge of knowledge on orthopaedics. Not high street cataract day surgery which can happily exist in the private sector.
I think that based on need, there is room for both but we do have a staggeringly valuable resource in the NHS and we should never lose sight of that being our primary health care provider. If more funding is needed, I for one would happily accept a higher personal taxation burden on NI.
When I was still in software, the project management company I ran had quite a strong base in pharmaceuticals. Clients included GSK and notably Pfizer. The latter spent circa $50 Million on a combination of our software and consulting to implement it and the reason was they wanted to reduce their time and cost to market of any given block buster drug. Because of FDA and our equivalent safety regulations, the cost to get a significant new drug through clinical trials with all the R&D can be up to $500M. Combine that with the time limit on patent laws and you start to develop an understanding why the drug firms want to claw back their R&D investment. Of course they make substantial profits but look at the increase in health outcomes we've all enjoyed over the last 50 years. Staggering improvements in all areas including the big ones like cancer and heart disease. The fact is that whether peoples personal politics agree or disagree with it, a market economy coupled with our superb NHS is a business model that has improved clinical outcomes at a staggering rate. So much so that now we cant afford as a country to pay for their extra longevity. The model is so successful its driven the pension crisis.
It's also true that "some" procedures are better done in the private sector. Simple, repeatable, non chronic procedures can easily be handled by the private sector more efficiently than the NHS. Where the NHS scores really highly is in complex, chronic, multi-faceted diseases. Exactly like the kind my family has been through recently. Cancer being one and a rare bone disease requiring a specialist orthopaedic hospital the other. Take my sons case, his bone disease is so rare there are only about 300 cases in the country. He needed a specialist, research, teaching hospital where the decision making is at the cutting edge of knowledge on orthopaedics. Not high street cataract day surgery which can happily exist in the private sector.
I think that based on need, there is room for both but we do have a staggeringly valuable resource in the NHS and we should never lose sight of that being our primary health care provider. If more funding is needed, I for one would happily accept a higher personal taxation burden on NI.
Phil Pascoe
Established Member
"If more funding is needed, I for one would happily accept a higher personal taxation burden on NI."
And more next year? And more the year after? This is the problem - the GDP could be thrown at it. It still wouldn't be efficient.
I turned down a ten minute assessment at Derriford hospital because I was unwilling to make a 160 mile round trip. I was told I should have taken a non emergency ambulance, which, with a three hour window for the appointment would have taken the ambulance and two staff out for the day. (An appointment materialised at my local hospital four miles away the following week).
A couple of weeks later my friend (a GP) said that the day before eight people from our area had made that journey... yes... you've guessed... eight ambulances and sixteen staff for a day.
That would have paid for a few meningitis jabs.
And more next year? And more the year after? This is the problem - the GDP could be thrown at it. It still wouldn't be efficient.
I turned down a ten minute assessment at Derriford hospital because I was unwilling to make a 160 mile round trip. I was told I should have taken a non emergency ambulance, which, with a three hour window for the appointment would have taken the ambulance and two staff out for the day. (An appointment materialised at my local hospital four miles away the following week).
A couple of weeks later my friend (a GP) said that the day before eight people from our area had made that journey... yes... you've guessed... eight ambulances and sixteen staff for a day.
That would have paid for a few meningitis jabs.
Random Orbital Bob
Established Member
No ones disagreeing efficiency savings could be made but I tell you something about the NHS, its a staggeringly complex organisation and any consulting firm who thinks they can just breeze in and "fix" it overnight are absolutely kidding themselves.
The thing that makes me feel so terribly sorry for the staff who are just dam hard working and for the vast majority genuinely caring people is the constant re-organisation. To put that in perspective, the company I ended up running had 4 ownership changes during my time there. Each brought some good, some bad. This was a circa $75M turnover company so not huge by major corporate standards at all. Employed about 650 people worldwide.
Each of those reorganisations took years to bed down and had huge impacts on operational procedures. Just imagine the scale of the change when they reorganise the NHS and the associated impacts on clinical outcomes. In my personal view the NHS is actually too complicated to be "fixed" in the normal sense of the word. The nature of its work, its geographical distribution and its culture are all too diverse to rationalise it in the way that say an acquisitive company sticks all its back offices together and sacks the incoming staff.
With each new administration comes a stupidly over excitable need to "prove" how tough and clever they are so they reorganise again and again failing to realise the troops are still reeling from strategy changes 15 years since. Like I said, its the folks at the coal face that have my sympathy and respect.
The thing that makes me feel so terribly sorry for the staff who are just dam hard working and for the vast majority genuinely caring people is the constant re-organisation. To put that in perspective, the company I ended up running had 4 ownership changes during my time there. Each brought some good, some bad. This was a circa $75M turnover company so not huge by major corporate standards at all. Employed about 650 people worldwide.
Each of those reorganisations took years to bed down and had huge impacts on operational procedures. Just imagine the scale of the change when they reorganise the NHS and the associated impacts on clinical outcomes. In my personal view the NHS is actually too complicated to be "fixed" in the normal sense of the word. The nature of its work, its geographical distribution and its culture are all too diverse to rationalise it in the way that say an acquisitive company sticks all its back offices together and sacks the incoming staff.
With each new administration comes a stupidly over excitable need to "prove" how tough and clever they are so they reorganise again and again failing to realise the troops are still reeling from strategy changes 15 years since. Like I said, its the folks at the coal face that have my sympathy and respect.
finneyb
Established Member
Jacob":1vzseatz said:
We need the private sector ie pharmco in this case, to develop the new drugs and vaccines, Govt funded research will never do it, there is simply not the incentive; they are interested in widening the knowledge base, which is useful, but it does not deliver on drug development etc for good reason the Govt does not have the ability to get drugs etc through approvals process nor the ability to manufacture the drugs etc.
The private sector is the most effective at drug development and manufacture; which means that not only is it most cost effective but also the most effective in terms of time to market, simply because their return on investment depends upon it. Public sector/Govt organisations are taxpayer funded on an annual basis NOT on what they produce.
The return on investment also serves to encourage NHS employees to get qualifications and experience, the more they have the more they are paid, so I see little difference between private and public sector philosophy they are all money driven, as is society.
The private & public sector working together, each to their strengths, is the best solution.
Brian
finneyb
Established Member
phil.p":x0svp7dj said:
I'm not certain about how efficient the NHS is, or how you would measure it. BUT US spend 16% of GDP while we spend 8-9% of GDP from memory; and the Yanks don't live any longer than we do, so something is being done that's correct.
If you have concerns about specific inefficiencies I would speak to your CCG, Clinical Commissioning Group, each local authority area has one - they hold the purse strings. The NHS Constitution Core Principle 6 ' The NHS is committed to providing best value for taxpayers’ money and the most effective, fair and sustainable use of finite resources. ' applies http://www.nhs.uk/NHSEngland/thenhs/abo ... iples.aspx
Brian
finneyb
Established Member
Random Orbital Bob":1if4tfri said:
The Kings Fund has a very good slide on NHS complexity http://www.kingsfund.org.uk/sites/files ... mation.pdf
Constant re-organisation - the NHS needs to be constantly re-organising to reflect the constantly changing societal needs and treatment availabilities. If we still had the 1948 model we would be in real difficulties. Perhaps the NHS needs to move to a culture where change is the norm, because in reality it is.
I suppose the difference could be in the wording ie it feels better to re-organise rather than to be re-organised.
Brian
