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From: Andy Hall on 11 Jul 2008 02:30 On 2008-07-11 05:53:41 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: > On Thu, 10 Jul 2008 21:27:05 +0100, Andy Hall <andyh(a)hall.nospam> > wrote: > >> On 2008-07-09 07:37:17 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: >>> > >>> but the private sector is much, much worse. >> >> That simply isn't true. > > ... according to your free market dogma. The facts argue otherwise. Relevent citation? > >> >> >> >>> And there is at least some slim chance that public services can be >>> held to account for their mistakes and forced to change their ways. >> >> That isn't true either. There is virtually zero chance of holding to >> account an organisation that actively markets that it is doing its >> customers a favour and that they should be grateful for what they get, >> >> Most NHS bodies have had immunity from prosecution lifted as of last >> year, but continue to operate as though they are above the law. > > So, just like private sector corportations, in the health sector and > elsewhere. Except, unlike with private corporations, there is some > slim chance of using the political process to bring pressure to bear > on them. In your dreams. The way to handle this issue is for the private sector contracts to contain sufficiently tight SLAs with appropriate non-performance penalties. The risk factor would be with the inability of civil servants to negotiate such a thing because they don't have the real world commercial experience. >> >> You already indicated that several private sector firms had been called >> to account in th courts, and within reason, that is a good thing. > > Now you are simply making things up. My post never mentioned private > sector firms being held to account by the courts. I beg your pardon, it was DaveT, earlier in the thread. > If I had, it would > have been to argue that fines just don't cut it when corportations > cause deaths by cutting corners in the chase for profits That's just silly hysteria. It's prfectly possible to negotiate contracts that will address that and to measure them. There is less motivation for a private sector company to cut corners unsafely because of the resulting publicity. I am far more concerned about the NHS methodology of spreading available funds as thinly as possible in order to maximise the number of patients treated, while wasting a significant proportion on unnecessary bureaucracy.
From: DaveT on 11 Jul 2008 06:55 On Thu, 10 Jul 2008 21:27:05 +0100, Andy Hall wrote: > On 2008-07-09 07:37:17 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: >> >> The public sector isn't very good or efficient at running complex >> expensive health services, > > That's certainly true, and they shouldn't be attempting it. > > >> but the private sector is much, much worse. > > That simply isn't true. > Name one of the service sectors that are now better run after Thatcher privatised them. Or as Harold McMillan said gave them away. Railways, terrible safety record since privatisation, time keeping worse not better, no competition. Telecoms, worse BB in Europe the ISPs get the blame for the slow speeds on BB but it is BT wholesale that is not upgrading from copper. As for BT itself it did a an equipment test that data pimped into its customers Internet browsing that was against the data protection act because they not only did not get permission but did not even inform the customers that were involved. Result one of the people involved in the desision to run the pimping now works for the advertising company that was involved in the test. As for phone service how can there be true competition when they still hold control of the wires through BT Wholesale. Buses that is the biggest laugh, in our area there was 8 companies running into our bus station after the big split up that was supposed to bring competition we have Arriva. Because the organising of bus services was taken away from councils many services have been dropped and those that are running are always breaking down because they are running with 40 year old vehicles and do not waste money restocking. The Post Office is now trying its utmost to fail so the rest will go to the private sector (and guess who will run it). The only good thing private companies are good at is asset stripping the problem is trying to find out were the money gained goes to, it certainly does not go into providing a better service. Then we have school dinners, hospital cleaning, BA the list goes on. -- DaveT T1 Basal Beef Lente Bolus Humalog as required.
From: Dave A on 11 Jul 2008 07:23 On Fri, 11 Jul 2008 07:30:43 +0100, Andy Hall <andyh(a)hall.nospam> wrote: >On 2008-07-11 05:53:41 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: > >> On Thu, 10 Jul 2008 21:27:05 +0100, Andy Hall <andyh(a)hall.nospam> >> wrote: >> >>> On 2008-07-09 07:37:17 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: >>>> >> >>>> but the private sector is much, much worse. >>> >>> That simply isn't true. >> >> ... according to your free market dogma. The facts argue otherwise. > >Relevent citation? Proper studies are a bit thin on the ground because information both about costs and clinical outcomes from corporate providers are "commercially sensitive". The overwhelming weight of anecdotal evidence is that clinical outcomes from the corporate sector treating NHS patients is no better, and sometimes worse, than for those treated within the NHS, despite the private sector being able to cherry pick those who are treated. If it were cheaper to treat in the private sector, it is likely that the politicians who favour moving in that direction (i.e. virtually all of them) would be shouting this from the rooftops, instead of justifying it by pointing to patient satisfaction surveys saying their private sector treatment was good because the toilets were clean and they got definite appointment times. > <snip > > >In your dreams. The way to handle this issue is for the private >sector contracts to contain sufficiently tight SLAs with appropriate >non-performance penalties. The risk factor would be with the >inability of civil servants to negotiate such a thing because they >don't have the real world commercial experience. > Such a system would totally exclude any public scrutiny because those of us who actually fund the health service through our taxes, and need its services when our health goes, couldn't be allowed to know *anything* - because of "commercial sensitivity". One place that corporations chasing government contracts don't cut corners is in lobbying the politicians and civil servants who are responsible for handing out the contracts. It is also very strange how many of these politicians and senior civil servants carry on being insulated from the real world commercial experience of most of us by transferring into well paid jobs in the very corporations they have helped to give contracts to, once their term in office is up. > > <snip > > >> If I had, it would >> have been to argue that fines just don't cut it when corportations >> cause deaths by cutting corners in the chase for profits > >That's just silly hysteria. It's prfectly possible to negotiate >contracts that will address that and to measure them. There is less >motivation for a private sector company to cut corners unsafely because >of the resulting publicity. Just like other anti-social types, they often think they won't be found out. MRSA and other bugs since hospital cleaning was privatised. Herald of Free Enterprise. Hatfield. >I am far more concerned about the NHS methodology of spreading >available funds as thinly as possible in order to maximise the number >of patients treated, while wasting a significant proportion on >unnecessary bureaucracy. > Have you any evidence the private sector has less bureaucracy, or less fat cats on less dosh? Or perhaps that a fat bloke with a red suit and a bushy beard delivers presents to every child each December.
From: Andy Hall on 11 Jul 2008 07:52 On 2008-07-11 11:55:23 +0100, DaveT <justask(a)private.org> said: > On Thu, 10 Jul 2008 21:27:05 +0100, Andy Hall wrote: > >> On 2008-07-09 07:37:17 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: >>> >>> The public sector isn't very good or efficient at running complex >>> expensive health services, >> >> That's certainly true, and they shouldn't be attempting it. >> >> >>> but the private sector is much, much worse. >> >> That simply isn't true. >> > Name one of the service sectors that are now better run after Thatcher > privatised them. Or as Harold McMillan said gave them away. > Railways, terrible safety record since privatisation, time keeping worse > not better, no competition. Therein lies the problem. Inept negotiation of contracts by the civil servants responsible for doing so. > > The Post Office is now trying its utmost to fail so the rest will go to > the private sector (and guess who will run it). The Post Office was past its sell by date years ago. It's an untenable business with an apalling customer service culture. I think that it will be very good when it finally exits the market and prices to deliver paper mail increase to commercially viable levels with a proper level of service.
From: Andy Hall on 11 Jul 2008 08:17
On 2008-07-11 12:23:00 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: > On Fri, 11 Jul 2008 07:30:43 +0100, Andy Hall <andyh(a)hall.nospam> > wrote: > >> On 2008-07-11 05:53:41 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: >> >>> On Thu, 10 Jul 2008 21:27:05 +0100, Andy Hall <andyh(a)hall.nospam> >>> wrote: >>> >>>> On 2008-07-09 07:37:17 +0100, Dave A <dave_a(a)NO~SPAMtiscali.co.uk> said: >>>>> >>> >>>>> but the private sector is much, much worse. >>>> >>>> That simply isn't true. >>> >>> ... according to your free market dogma. The facts argue otherwise. >> >> Relevent citation? > > Proper studies are a bit thin on the ground because information both > about costs and clinical outcomes from corporate providers are > "commercially sensitive". The overwhelming weight of anecdotal > evidence is that clinical outcomes from the corporate sector treating > NHS patients is no better, and sometimes worse, than for those treated > within the NHS, despite the private sector being able to cherry pick > those who are treated. Anecdotal evidence is not all that valuable because of the limited number of data points and the non scientific analysis of the data. Anecdotally, my experience of private sector medicine has never been less than exemplary. > > If it were cheaper to treat in the private sector, it is likely that > the politicians who favour moving in that direction (i.e. virtually > all of them) would be shouting this from the rooftops, instead of > justifying it by pointing to patient satisfaction surveys saying their > private sector treatment was good because the toilets were clean and > they got definite appointment times. That would be a start. Multiple occupancy wards and shared toilets should be replaced by individual rooms and separate toilet facilities. A few years back, I had the misfortune to be treated for a few hours in an NHS hospital, until I discharged myself and went to a private facility. The NHS facilities were indescribably bad. The 1Bn a year that is being spent on hospital infections would be far better spent on removing communal accommodation. >> <snip > >> >> In your dreams. The way to handle this issue is for the private >> sector contracts to contain sufficiently tight SLAs with appropriate >> non-performance penalties. The risk factor would be with the >> inability of civil servants to negotiate such a thing because they >> don't have the real world commercial experience. >> > Such a system would totally exclude any public scrutiny because those > of us who actually fund the health service through our taxes, and need > its services when our health goes, couldn't be allowed to know > *anything* - because of "commercial sensitivity". It would be perfectly simple to build appropriate transparency into the contracts. > > One place that corporations chasing government contracts don't cut > corners is in lobbying the politicians and civil servants who are > responsible for handing out the contracts. It is also very strange how > many of these politicians and senior civil servants carry on being > insulated from the real world commercial experience of most of us by > transferring into well paid jobs in the very corporations they have > helped to give contracts to, once their term in office is up. Examples? >> >> <snip > >> >>> If I had, it would >>> have been to argue that fines just don't cut it when corportations >>> cause deaths by cutting corners in the chase for profits >> >> That's just silly hysteria. It's prfectly possible to negotiate >> contracts that will address that and to measure them. There is less >> motivation for a private sector company to cut corners unsafely because >> of the resulting publicity. > > Just like other anti-social types, they often think they won't be > found out. MRSA and other bugs since hospital cleaning was > privatised. Actually, a lot of that was because of excessive use of antibiotics, but leaving that aside, again this could be dealt with via appropriate contract provisions. > >> I am far more concerned about the NHS methodology of spreading >> available funds as thinly as possible in order to maximise the number >> of patients treated, while wasting a significant proportion on >> unnecessary bureaucracy. >> > Have you any evidence the private sector has less bureaucracy, or less > fat cats on less dosh? This "fat cats" notion from the popular press amuses me. The equation is a perfectly simple one of needing to pay adequately to attract the best people to run the organisations and to fire them if they don't perform. Contrast this with the civil service having a grade system and final salary pension schemes where people ar promoted rather than being fired for incompetence. > Or perhaps that a fat bloke with a red suit > and a bushy beard delivers presents to every child each December. John Prescott? |