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David Osland (at the other place) offers a wonderfully concise critique of the utilisation of the private sector to deliver public goods.... 'We're told pensions are 'unsustainable', the Post Office is 'unsustainable' & now that the NHS is 'unsustainable'. They were all entirely sustainable before the private sector starting looting the public sector'! Yup, that's about it.... 37 comments
@matthewtoad43 @ChrisMayLA6 Measuring hours vs output is such a diseased thought process. But it can be hard to manage as a framework of autonomous, repsonsible people; because bad actors may not be any of those things, and it sadly needs beurocracy to ensure checks and balances are kept. Hard on this one. @matthewtoad43 @lewiscowles1986 @ChrisMayLA6 Innovation in the public sector exposes the lie that nobody does their best unless there is competition, but some people do their best work when there is less pressure and they don't fear failure. @matthewtoad43 @lewiscowles1986 @ChrisMayLA6 there is a whole government funded movement of which NICE is part, to prevent innovation in the NHS. The IHI lambasts any variation from mean, hence blocks improvement! Variation must precede improvement.... @ChrisMayLA6 the purpose of Thames water (and most the other firms) isn't to manage the supply of water and treat sewage. Their purpose is to produce as big a return as possible to investors*, the water network is just an asset they can use for that. So they can borrow massively against it (knowing the gvmt won't let it completely crumble but won't intervene due to ideology), cut maintenance, etc. @howard @sideshow_jim @ChrisMayLA6 I’ve never come across POSIWID before, and I think it’s a brilliant insight. We should apply it to LLM AI, too! @ChrisMayLA6 which complete idiot thought adding profit extraction to a system wasn't going to kill it? #ThatcherWasWrong #BlairDidntFixIt Now there is nothing left and we have to rebuild our destroyed home. #ScotlandCanDoBetterThanThis #NothingToLose #ScottishIndependence #YouYesYet  That, plus the failure to tax the rich.  The PM is married to Akshata Murty, whose family boasts a fortune of over £500 million, leading to accusations that he is out of touch with ordinary Britons grappling with the cost of living crisis. @ChrisMayLA6 As long as people are alive, we'll always have to deal with it. It's something that's not been resolved throughout millennium. @ChrisMayLA6 The logic seems straightforward to me. Take the NHS as an example. An NHS which uses more and more private resource will not cost us less as we still have to pay for everything we currently pay for but we also have to stump up for profits. As shown by water infrastructure, private big business is way more interested in bonuses than it is in investing in the business. So an NHS with more privatisation will cost more and get worse. @IndyRichard @ChrisMayLA6 they don't care how much it costs, as long as they can cream off tax payers money into their offshore accounts.  @IndyRichard @ChrisMayLA6 very well put. And amply demonstrated by England’s experience with privatised water companies.  @IndyRichard @ChrisMayLA6 When Labour comes to office it'll be full steam ahead for privatisation of the NHS according to Wes Streeting And if by some miracle the Torys get back in the NHS won't last the year We need to try for a coalition & get some of the smaller parties in office @staringatclouds @IndyRichard @ChrisMayLA6 fingers cross Streeting loses his seat. I’d love it if Lammy, Reeves and Starmer got binned too, but that’s my Friday fantasy. I note Emily Matias and Lewis Goodall are also questioning whether Labour will be any different to the Tories @Lassielmr @staringatclouds @IndyRichard @ChrisMayLA6  @staringatclouds @IndyRichard @ChrisMayLA6 that man is a traitor to the NHS and to Queers. I would send money to a campaign in his constituency for "Anyone But Wes", the gaslighting shallow prick..... @IndyRichard @ChrisMayLA6 Whilst I am not in any way in favour of the privatization of healthcare services, the current privatization drive may nevertheless result in the massive slimming down of the hugely overweight bureaucracy currently absorbing a disproportionate percentage of the NHS budget! Hmmm... well, as I understand it, the bloated bureaucracy is directly linked to putting in places & maintaining the conditions for an 'internal market' in the NHS.... my guess is like US healthcare, more 'privitaisation' will result in more managers not less.... @Paulos_the_fog @ChrisMayLA6 A disproportionate percentage of the NHS budget is spent on servicing PFI debt. Yet another example of private sector taking from the NHS. Am not at all convinced anything will improve with yet more private involvement. @Paulos_the_fog @IndyRichard @ChrisMayLA6 Managers make up just less than 3% of NHS workforce. Recent research by Institute for Public Policy Research suggested that the healthcare sector is under-managed, and this increases the burden of bureaucracy that falls on frontline professionals. @Lassielmr @Paulos_the_fog @IndyRichard Thanks, a little counter-intuitive, but I'm sure that's right - so then the Q. is what sort of management is actually taking place - clinical administration, or the required admin to make the 'internal market' work?  @Lassielmr @Paulos_the_fog @IndyRichard @ChrisMayLA6 Excellent so all those middle managers universities don't need could move into the NHS and solve two problems at once.  Pensions, most especially nationally funded ones, are pro bono publico pyramid schemes that require an ever larger economic earning population either by size or value. The Post Office/Royal Mail monopoly was broken and underfunded and prevented from adapting (becoming the Internet of last resort etc). The NHS was reorganised to insanity and spends more on delivery and internal inefficiencies than it does providing health care. Private contracting is just one factor. A situation in point. A patient treated in more than one Trust (sometimes different parts of the same Trust) will get the treatment and be not too aware of the differences. Internally there will be cross Trust, inter Trust negotiations, arguments, fallings out billing reconciliation and in the case where something horrible happened to the patient legally fallout. @ChrisMayLA6 I was about to comment that the only thing they haven't privatised was law making & parliament. But then I read about Greensill and Cameron, and realised that they have already! Just not announced it. See payments from Health Co.s, Arms suppliers, Builders, to MPs ministers & Shadow ministers. Lords full of people buying their seat.  @ChrisMayLA6 All of those things are perfectly sustainable, just need to remove the lampreys of private sector placed there by iterative governments trying to kill them so they'll get a nice payday out of it later.  @ChrisMayLA6 and when tax rates on the rich were considerably higher and when companies making sales in UK had to pay full tax in UK rather than pay some offshore tax haven company massive amounts to use the name even though not a proper franchise @ChrisMayLA6 @ChrisMayLA6 all the indicators of civilisation are apparently unsustainable, so perhaps we need to go back to the stone age |
Gregory's Server
@ChrisMayLA6 Why don’t they just admit it, england is unsustainable.