THE FOURTH OF JULY

[Jacob]

The NHS in its present form is an unsustainable money pit, which the incoming Government will struggle to turn around. Healthcare spending in the UK as a share of the gross domestic product (GDP) was 5.1 percent in 1990. By 2022, healthcare expenditure had risen to 11.3 percent of GDP. (Fourth highest in Europe:12.8% of GDP in Germany, 12.4% in France, 12.2% in Austria).

......

It is still cheaper and more effective than any private care system could possibly be.
There's no reason why we should not aim at having the highest expenditure and the highest level of care in Europe.
I really don't understand why so many people argue frantically against civilisation, and at such great lengths as we see above, even when they personally are getting the benefit of it at so many levels.

 

[Jacob]

Pessimistic view of Starmer coming up (quelle surprise!) that he will win for Labour but with far fewer votes than Corbyn in 2017.
In fact it's looking a dead cert at the mo, I might a few bob on it.

 

[RobinBHM]

The NHS in its present form is an unsustainable money pit

The NHS in its present form is an unsustainable money pit, which the incoming Government will struggle to turn around. Healthcare spending in the UK as a share of the gross domestic product (GDP) was 5.1 percent in 1990. By 2022, healthcare expenditure had risen to 11.3 percent of GDP. (Fourth highest in Europe:12.8% of GDP in Germany, 12.4% in France, 12.2% in Austria).

You’ve rather proven the point that the NHS is under funded, not an unsustainable money pit.

 

[RobinBHM]

I might a few bob on it

You might bump into a Tory MP down the bookies….I hear it’s on trend for them

 

[selectortone]

Pessimistic view of Starmer coming up (quelle surprise!) that he will win for Labour but with far fewer votes than Corbyn in 2017.
In fact it's looking a dead cert at the mo, I might a few bob on it.

Curious readers might like to visit Jacob's OT2 'A New Leadership' thread (120+ pages and counting) in which he explains why Labour losing two elections in a row is a good thing, while winning one now would be a bad thing.

 

[sploo]

You’ve rather proven the point that the NHS is under funded, not an unsustainable money pit.

Also currently a victim of stealth privatisation. One tactic my (NHS doctor) wife has observed is the contracting out of various roles to private companies (usually for more money than the full time staff are being paid). Full time staff get (rightly) annoyed by this, and leave; thus creating more spaces that get filled by private sector contractors. Insidious, but quite effective; if your goal is to slowly destroy the NHS and create a private sector service instead.

 

[Terry - Somerset]

Also currently a victim of stealth privatisation. One tactic my (NHS doctor) wife has observed is the contracting out of various roles to private companies (usually for more money than the full time staff are being paid). Full time staff get (rightly) annoyed by this, and leave; thus creating more spaces that get filled by private sector contractors. Insidious, but quite effective; if your goal is to slowly destroy the NHS and create a private sector service instead.

There may be some benefit in articulating the extent of "privatisation".

The total costs of the NHS in 2022/23 was £182bn - £171bn running expenses and £10bn investment. Total staff costs of the NHS in 2022/23 was £71bn

The balance of costs of £110bn were all external services - includes drugs, equipment, catering, cleaning, dentistry, running car parks, building projects etc etc.

Much of this external spend is unremarkable - most would not expect the NHS to research and manufacture its own drugs, medical equipment, run construction companies etc. Other services closer to the patient are also contracted out - catering, cleaning.

However health critical services are delivered by the private sector:

• Dentistry is a mess, not because it is delivered by the private sector, but because NHS funding is clearly inadequate.
• GP surgeries have been private businesses since the NHS was established working under contract to the NHS.
• Opticians
• Other services are private sector provided - chiropody, elderly care, rehab services etc

IMHO we should focus on getting the best patient care which must include managing external contracts better.

The dogma driven conclusion that all privatisation is "bad" is a flawed. NHS "free at the point of use" is an important statement of intent - but they are not the sole source of best practice and ideas. Properly managed input from the private sector can add to service quality and value.

 

[Jake]

Pessimistic view of Starmer coming up (quelle surprise!) that he will win for Labour but with far fewer votes than Corbyn in 2017.
In fact it's looking a dead cert at the mo, I might a few bob on it.

But that's kind of an of irrelevant metric. In terms of vote efficiency, Starmer is building a platform that delivers power to the (broad) left rather than to the right like Corbyn did. Lots of votes in very lefty places is all very well for a leader of protest like Corbyn but not much use in actually effecting political change.

 

[Jacob]

There may be some benefit in articulating the extent of "privatisation".

........
The dogma driven conclusion that all privatisation is "bad" is a flawed. NHS "free at the point of use" is an important statement of intent - but they are not the sole source of best practice and ideas. Properly managed input from the private sector can add to service quality and value.

The dogma is with the right, with simplistic notions about a smaller state and lower taxes.
The left is more about getting things done.
The simple fact about private health care is that probably 75% of the population could not afford it at all, and some procedures would bankrupt even the very well off.

 

[Jacob]

But that's kind of an of irrelevant metric. In terms of vote efficiency, Starmer is building a platform that delivers power to the (broad) left rather than to the right like Corbyn did. Lots of votes in very lefty places is all very well for a leader of protest like Corbyn but not much use in actually effecting political change.

Am not aware of Starmer building anything at all - unless you count this as a platform* for example https://www.middleeasteye.net/news/...ts-countries-bangladesh-are-not-being-removed!
This notion of "voting efficiency" is a bit delusory and the imbalances are just a feature of boundaries and demographics, affecting left and right similarly.
*PS or this https://www.opendemocracy.net/en/be...-tory-mistakes-on-migration-general-election/

 

[Jacob]

Am not aware of Starmer building anything at all - unless you count this as a platform* for example https://www.middleeasteye.net/news/...ts-countries-bangladesh-are-not-being-removed!
This notion of "voting efficiency" is a bit delusory and the imbalances are just a feature of boundaries and demographics, affecting left and right similarly.
*PS or this https://www.opendemocracy.net/en/be...-tory-mistakes-on-migration-general-election/

Amongst the fog of this chaotic election it's nice to find a bit of clarity; https://www.theguardian.com/comment...eir-starmer-labour-britain-conservative-party
"..........as things stand least plausible option, is that Starmer’s Labour becomes that party of change, rather than the party that has changed."

 

[RobinBHM]

Also currently a victim of stealth privatisation. One tactic my (NHS doctor) wife has observed is the contracting out of various roles to private companies (usually for more money than the full time staff are being paid). Full time staff get (rightly) annoyed by this, and leave; thus creating more spaces that get filled by private sector contractors. Insidious, but quite effective; if your goal is to slowly destroy the NHS and create a private sector service instead.

I once built an orangery for a guy who ran a consultancy / recruitment firm mostly to the NHS

He had a £2m house in Sussex, a large Manor House in Portugal and he drove a top of the range Porsche.



I believe recruitment agencies supplying bank staff to NHS, Drs, nurses etc make huge amounts of money.


And we have GP surgeries that have had their budgets cut and can’t afford to get in locums when needed. Locums are complaining they can’t get enough work. ( I know they charge a lot, around £650 a day)

 

[RobinBHM]

But that's kind of an of irrelevant metric. In terms of vote efficiency, Starmer is building a platform that delivers power to the (broad) left rather than to the right like Corbyn did. Lots of votes in very lefty places is all very well for a leader of protest like Corbyn but not much use in actually effecting political change.

Jeremy Corbyn has done a great deal of damage to British politics.

His strategy was to focus only on the liberal left….so he got lots of votes but achieved nothing. What he did was sell a false dream to millions of leftists who believe he “almost won” (he didn’t he won a derisory 30 seats)

We now have lots of leftists who think you just have to believe harder.


I wonder if these left wing supporters who have all gone to the Green Party will get disillusioned after a few years, as they will be stuck in wilderness getting zero publicity whilst Labour as the govt will be front page news every day

 

[Keith Cocker]

Pessimistic view of Starmer coming up (quelle surprise!) that he will win for Labour but with far fewer votes than Corbyn in 2017.
In fact it's looking a dead cert at the mo, I might a few bob on it.

But the important thing will be that Starmer won and Corbyn didn’t win. The devil ISN’T in the detail.

 

[selectortone]

But the important thing will be that Starmer won and Corbyn didn’t win. The devil ISN’T in the detail.

Good luck with that. People have been telling Jacob that for 120+ pages in a thread in the OT2 forum. You can take a horse to water but you can't make it drink.

 

[Yorkieguy]

It is still cheaper and more effective than any private care system could possibly be.
There's no reason why we should not aim at having the highest expenditure and the highest level of care in Europe.
I really don't understand why so many people argue frantically against civilisation, and at such great lengths as we see above, even when they personally are getting the benefit of it at so many levels.

The point I was trying to make, which seems to have been lost, is that its the public (us), that through unhealthy lifestyles, and placing what will become an unsustainable burden on the NHS. We don't provide 'the highest level of care by treating chronic illnesses which are largely preventable. Prevention is far better than cure (there is no cure for chronic ill health.

As I said, for the three years 2020–22, although male life expectancy was 78.8 years, only 62.4 years will have been in reasonable (but declining) health, and16.4 of those years (21%) would have been spent in poor health, much of it self-induced. Female life expectancy was 82.8 years, of which of which 20.1 of those years (24%) will have been in ill health. Not only does this place a huge and increasing burden on the NHS, and hence, public finances, it makes people economically inactive, and to spend 1/4 of their lives in ill health seems to be a pretty miserable state of affairs.

I mentions that the prevalence of obesity (BMI ≥ 30kg/m²) in the UK in 2022 is: Women: 28.3%, Men 26.94%. (For comparison: USA: Women 43.82%, Men 41.64%. For France, it's much lower: Women 10.18%, Men, 9.82%). So unless anything chances soon, and I doubt that it will, it won't be too long till we're heading in America's direction.

I mentioned that Healthcare spending in the UK as a share of the gross domestic product (GDP) was 5.1 percent in 1990. By 2022, healthcare expenditure had risen to 11.3 percent of GDP. (Fourth highest in Europe:12.8% of GDP in Germany, 12.4% in France, 12.2% in Austria).

So with healthcare spending as a %age of GDP having more than doubles since 1990, it isn't about 'Tory cuts' or whatever, and the amount the UK spends on the NHS is almost the highest it Europe. If we always do what we always did, we'll always get what we always got - an increasingly unfit nation, and yet more money needed to treat the consequences.

For the welfare of his animals, a seaside donkey proprietor which allows kids aged under ten, has had to imposes a six stone weight limit and has scales to weight kids. Yes - six stone ten year olds. Inevitably, rather than people wondering how kids can be so obese, he's been accused of 'fat shaming'.

https://www.dailymail.co.uk/news/ar...onkey-boss-obesity-row-weighing-children.html

And for the avoidance of doubt, I'm not a Daily Mail reader!

 

[Jacob]

The point I was trying to make, which seems to have been lost, is that its the public (us), that through unhealthy lifestyles, and placing what will become an unsustainable burden on the NHS. We don't provide 'the highest level of care by treating chronic illnesses which are largely preventable. Prevention is far better than cure (there is no cure for chronic ill health.

Well yes more action could be taken on unhealthy lifestyles but that would be directly against the current zeitgeist of de-regulation, "nanny state" and similar inanities.
Loadsa dosh made from cheap food, fags, booze, loads more to be made treating obesity and other consequences, it's win win!!

 

[Kittyhawk]

The point I was trying to make, which seems to have been lost, is that its the public (us), that through unhealthy lifestyles, and placing what will become an unsustainable burden on the NHS. We don't provide 'the highest level of care by treating chronic illnesses which are largely preventable. Prevention is far better than cure (there is no cure for chronic ill health.

As I said, for the three years 2020–22, although male life expectancy was 78.8 years, only 62.4 years will have been in reasonable (but declining) health, and16.4 of those years (21%) would have been spent in poor health, much of it self-induced. Female life expectancy was 82.8 years, of which of which 20.1 of those years (24%) will have been in ill health. Not only does this place a huge and increasing burden on the NHS, and hence, public finances, it makes people economically inactive, and to spend 1/4 of their lives in ill health seems to be a pretty miserable state of affairs.

I mentions that the prevalence of obesity (BMI ≥ 30kg/m²) in the UK in 2022 is: Women: 28.3%, Men 26.94%. (For comparison: USA: Women 43.82%, Men 41.64%. For France, it's much lower: Women 10.18%, Men, 9.82%). So unless anything chances soon, and I doubt that it will, it won't be too long till we're heading in America's direction.

I mentioned that Healthcare spending in the UK as a share of the gross domestic product (GDP) was 5.1 percent in 1990. By 2022, healthcare expenditure had risen to 11.3 percent of GDP. (Fourth highest in Europe:12.8% of GDP in Germany, 12.4% in France, 12.2% in Austria).

So with healthcare spending as a %age of GDP having more than doubles since 1990, it isn't about 'Tory cuts' or whatever, and the amount the UK spends on the NHS is almost the highest it Europe. If we always do what we always did, we'll always get what we always got - an increasingly unfit nation, and yet more money needed to treat the consequences.

For the welfare of his animals, a seaside donkey proprietor which allows kids aged under ten, has had to imposes a six stone weight limit and has scales to weight kids. Yes - six stone ten year olds. Inevitably, rather than people wondering how kids can be so obese, he's been accused of 'fat shaming'.

https://www.dailymail.co.uk/news/ar...onkey-boss-obesity-row-weighing-children.html

And for the avoidance of doubt, I'm not a Daily Mail reader!

It is so hard to understand why people just will not take care of themselves. I don't remember the figures now but the number of failing health issues directly attributable to food choices, lack of exercise, smoking and drinking are enormous. And yet a healthy regimen is so easy to institute with just a little discipline. Far better to rely on your own resources for the maintenance of your health than a cash strapped over subscribed government health service. As your friendly neighbourhood ambo, I used to get a bit cross with the same patients that I'd be dispatched to again and again - smokers with CORD and heavily distressed. So it was oxygen and salbutamol/ipratropium mix via a Hudson mask and maybe IM adrenaline if needed and as soon as they stabilized they'd be reaching for another fag. You've got to die of something, they'd say and I'd tell then it's not the dying they should be concerned with, it the years of misery beforehand. But it didn't dribble in with most of them. We only get one life and we need to nurture it.

 

[Spectric]

Prevention is far better than cure (there is no cure for chronic ill health.

But how do you get this message over to people, I am sure that many do know of the consequences of their lifestyles but choose to ignore it as it is there right and freedom to choose if they want to gamble with there health and shorten their lifespan. We have had generations of smokers and now all the consequences are there to see but you still see young people smoking, so if the thought of COPD and cancer does not deter them, then how do you get the message across and take a huge burden off the NHS. Then we go from one health issue and crash into another with vapping, another massive burden for the NHS in years to come. As Jacob has said

Loadsa dosh made from cheap food, loads more to be made treating obesity and other consequences, it's win win!!

This is the opposite side of the coin, just like countries make money from selling weapons without worrying about the end result there is money to be made from making people fat and unhealthy again without worrying about the end result. Prevention is the right thing to do, just like maintenance it would prevent bigger issues down the line that are often unexpected and more costly to rectify which comes down to the NHS taking a tougher stand, if you have wrecked your body through abuse then why should someone else pick up the tab. You also have the safety issue where you have large heavy people that cause problems for ambulance staff when they need to be moved, they need extra large wheel chairs and beds in hospital and are like HGV's on the pavements so a risk to others. All these problems would be resolved if they were on the NHS radar at a much earlier phase and preventative measures put in place and it would save the NHS more time and money later otherwise we will see ambulances looking like recovery trucks with a jib.

But we are powerless to fix any of these issues, no one is going to challenge peoples freedom or rights and there expectations that they will be looked after even if they have COPD and have lost there feet due to diabetes and any tax on junk food is just another tax on the poor, the wealthy escape yet again.

 

[Yorkieguy]

Just keeps getting swept under the rug doesn't it?

This petty little election of grifters all vying for their place in the limelight and the wealth that brings, will all be a moot point pretty soon if we don't get our act together

A sense of perspective might be worth considering perhaps?

• The UK’s emissions are now 53% below 1990 levels, while GDP has grown by 82%.
• The drop in emissions in 2023 was largely due to an 11% fall in gas demand. This was due to higher electricity imports after the French nuclear fleet recovered, above-average temperatures and weak underlying demand driven by high prices.
• Gas demand would have fallen even faster, but for a 15% fall in UK nuclear output.
• Coal use fell by 23% in 2023 to its lowest level since the 1730s, as all but one of the UK’s remaining coal-fired power stations closed down.
• Transport was the single-largest sector in terms of emissions, followed by buildings industry, agriculture and electricity generation. The electricity sector likely dropped below agriculture for the first time.

While the 23MtCO2e reduction in 2023 was faster than the 14MtCO2e per year average needed to reach net-zero by 2050.

https://www.carbonbrief.org/analysi...he latest 23MtCO2e (5.7%),, MtCO2e, 1850-2023

If climate protestors were really sincere in what they preach, they would lead their lives in a very different way from everyone else, but they don't. The drive diesel cars, have gas central heating, take long haul flights, use modern technology - mobiles phones, internet etc. All too often, they commit criminal damage and disrupt the lives of other, behaving like attention seeking naughty toddlers throwing tantrums when others don't indulge them. They band on about their rights of freedom of expression, forgetting that along with rights go responsibilities.

Article 10 of the Human Rights Act: Freedom of expression​

1. Everyone has the right to freedom of expression. This right shall include freedom to hold opinions and to receive and impart information and ideas without interference by public authority and regardless of frontiers. This Article shall not prevent States from requiring the licensing of broadcasting, television or cinema enterprises.

2. The exercise of these freedoms, since it carries with it duties and responsibilities, may be subject to such formalities, conditions, restrictions or penalties as are prescribed by law and are necessary in a democratic society, in the interests of national security, territorial disorder or crime...

It's a matter for the government of the day to decided how best to progress efforts to reduce emissions further and at what rate. (I don't think there are many climate change-deniers in Starmer's team).

Or so it seems to me.