definitely. I think ARTD does us Welsh a disservice by suggesting we cannot understand that the difference between NAW - the legislature and the WG - the executive.

Ye thats stupid I think hes completely missed the point nobody pays attention to the WAG anyway every Welsh election people seem to think its a UK election and vote for the parties based on their thought on what goes down in westminster.
I saw this comment on the guardian article about this story:

Bangorstu

10 August 2012 10:47AM
Response to cymraeg147, 10 August 2012 9:51AM

The North Welsh do not generally vote for Labour in any great numbers, Wrexham excepted.

So can we get rid of you socialist parasites from the Valleys and have our own Assembly?

Or are we doomed to distant Labour domination forever?
-----------------------------------------------------

I'd vote for that!

I did actually lol at that

Its a pity Nick Bourne lost his seat last year thought he was an excellent leader and now with that Leanne Wood(who is basically a trotskyist) as Plaid Leader the likelyhood of a anti-Labour coalition after the next election is zero, ARTD is hard to take serious as a leader comes across as an angry fat guy from Cowbridge he also seems to be obsessed with emphasising unionism as if Welsh independece is likely?
Looks like we'll have to put up with the socialist parasistes from the valleys for another few years after 2016

< http://www.independent.co.uk/news/uk/politics/exclusive-g4s-proves-we-cant-always-rely-on-private-sector-admits-minister-8038760.html >

... the private sector hasn't exactly been a dazzling success in rendering employment / benefits services ... and i could say pretty much the same for the Justice/Prison services


... I suppose as long as it's something trivial like hospitals we should be fine

pathetic argument, it really is.

there is no doubt that some aspects of private sector delivery go awry and when it does the operator is penalised and no doubt can risk losing the contract. What risk, if any, does the public sector have if it fails in its service delivery?

I have never said that the private sector has all the answers, what I have said is that we need a more mature debate in the UK about engagement with the private sector. Ideology should not play a part - what is best for the public and the taxpayer should take priority.

What risk from 'cut-price' health/justice/emergency services/etc???

I think that argument has a lot more substance than the wordplay over the naming of the Senedd/Senate

And let's be honest if the Assembly had any responsibilities in the G4S Olympics debacle some of us would be apoplectic about the prospects of us all being murdered in our beds

For the record I'm not saying that public sector should run and deliver these services as a divine right - far from it - there most certainly is a place for quality, 'ethical' private providers - but you began this thread with an example of political folly as a reason to "never trust a politician" - and I'm just saying be careful of capitalists

Jantra,

Thanks for your reply, as ever you are very comprehensive and well reasoned. Although I would argue that your point of view is based in political ideology just as much as everyone else is and yes I do think rationally and it is based on what is best for the people I look after and as far as I am concerned the balance sheet of a private company is not in their best interest.

I speak of the vested interest of the right wing media, example Daily Mail, Sky and so on.

I work for the NHS and pay my pension accordingly, I will remind you that the NHS pension returns a surplus of £2billion every year.An example of a well managed and funded pension that does not require any tax payer money. Although the government both Labour and Tory has seen fit to fuck me over!!

I will also correct you on a point of view that I refuse to accept public services provided by the private sector, I really couldn't give a rats arse, what I object to is profit making private companies taking huge amounts of tax payer money to provide public services and then promptly reducing pay and conditions whilst creaming off vast amounts of money to pay executives and shareholders. As far as I am concerned Jantra if you are running a 'private' company that is totally dependent on tax payer money then it is a way of circumventing the need to pay decent wages. I see very little evidence that the private sector is better than the public sector. You talk of monopolies, how about privatised utilities? Are they not monopolies that charge inflated prices for poor quality services?? Need I draw your attention to the joke that is railway privatisation?

Gareth

Thank you for your response, as ever I'll respond to your points as you have raised them.

I wouldn't necessarily say may point of view is ideological, more pragmatic about what we can and cannot afford and the fact that we need to consider all options, including engagement with the private sector


ignore the papers, read something like the www.bbc.co.uk/news which is far more impartial


I am afraid that is totally incorrect. I'd question whoever told you that. the NHS pension is a tax funded pension. That means HMT take the contributions from the NHS staff and use those funds to provide other public services in the years the contributions are made. It allows governments to keep taxes lower in that year and provide services over and above what they would have if relied upon taxation only. however, the drawback, and it is very big, is that the funds are not invested and as such, when it comes to pay the NHS pensions, funds are taken from taxation received in any given year to meet the liability.

whole of government accounts has shown that for every £1 contributed, £7 is likely to be paid out in return.


the fact is it is not well managed. it is not a pension fund per se. each successive government has used staff contributions to keep taxes lower instead of investing the contributions into funds. the assets held by NHS pensions nil as there is no fund, but they have a liability of around £100bn. Thats money that will be taken from taxation in future years rather than provide services in those years. It is effectively inter generational theft.


but what if the service that was delivered by the private sector was actually better and cheaper than what could be delivered by the public sector, even when the profit motive was factored in? Surely the point of public services should be to deliver the best possible service at the best possible value for the taxpayer? If the private sector can do this then the private sector should be used.


you assume that the higher resource costs of the public sector are affordable. They are not. with the higher average pay, longer holidays, less hours worked, higher sick days and extremely generous pensions, the UK public sector has become far too costly. it should never have got to that stage but it did. Perhaps it would be better to consider that for a while, the public sector worker had it better than what the nation could actually afford.


Hinchingbrooke???


I'm not necessarily going to disagree. I am not all for private sector delivery, I am more than happy to see services delivered by the public sector. I do not think either sector has a monopoly on delivering the best outcomes. I just think better engagement with the private sector should be feasible and not frowned upon. I don't see anything wrong with profit motive if it is within a tightly controlled framework where strictly controlled standards are adhered to. Its a case of if you [the private sector) can deliver what we (the public sector) are currently delivering and can do so cheaper, we'll split the difference. it really is win win.

Jantra,

In 2008/09 the NHS pension, after paying out to members had a surplus of £2.1 billion which was returned to HMT and I assume they spent the money wisely and effectively???
I would guess most people would call this an example of how to run a public sector pension, no need for the tax payer to prop-up my retirement!!

I think you misunderstand the concept of a business Jantra, a public service is not a business, it does not make anything or sell anything therefore it does not generate wealth. A business takes a product, makes something and then sells it so creating jobs, profits and wealth.

To say if a private company can provide a services cheaper then they should be encouraged (and yes as far as I am concerned go ahead and do it) is fine but again you miss the point. They don't do things cheaper, for example it cost £98.6 to run the NHS in 2008/09 lets say the government hands over that money to the private sector. They run the NHS and reduce costs by cutting staff, closing hospitals, reducing services, increase costs to patients such as prescriptions and parking (I live in England now by the way). They then say 'look, we saved £XX.XX whilst using the money to pay executives, share holders and company owners huge amounts of money.

I take exception to your ideological point of view that a private company should be able to keep the money it creams off the top of public services and call it profits, how exactly is that a win, win as you call it? You can't make a profit if you don't create something!! If you take money from the government and then and make a so called profit but slashing services as well as pay and conditions for the staff please tell me how that is good for anyone or cost effective for the tax payer. You can't actually believe that the overall bill for public services will go down if these companies are generating a so called profit buy the means I have mentioned, the overall bill will stay the same but it will look cheaper on paper because staff costs are less and the money is diverted in to the pockets of already wealthy individuals.

If I had any faith that the government would do things properly, ie maintain services and a decent and reasonable level of pay for workers then I would support the move to the private sector. As it stands there is very little evidence that any government is capable of doing anything properly.

I really don't understand why there is a race to the bottom in this country and a desire to return to a Victorian economy where a small number of people are massively super rich and the worker that keeps them there is reduced to a poverty wage and life of work until you drop.

Give me a government that runs the country properly, looks after it's population and creates wealth for everyone based on fairness and fair pay for fair work and I will vote for it red, blue, yellow, green or any other colour.

that is just not true. the NHS pension scheme is a funded scheme. it is funded directly from taxation and not from a pension fund. the LGPS is the only public sector pension scheme that is funded from investments (save for the very small university schemes



Gareth

all of that comes across very ideological. you seem to think that the private sector will come in and simply make profits by cutting costs ergo cutting services. that is just not true. the private sector is by and large not hamstrung by the needless bureaucracy and wasteful processes that are endemic within the public sector. It is here that the private sector can eliminate waste, improve productivity and output for a given resource.

at no point have I said we should adopt 'slash and burn' tactics. What I have said is that we can free up the service provider from the shackles of public sector inefficiency but they would have to deliver within a tightly regulated framework. Consider they have to deliver services to an agreed service level or they lose the contract. Think of Virgin and the West Coast Mainline. The service levels and cost to the rail user were just not at the level wanted and so they have lost the franchise. Now with a public sector operator there is no incentive to improve and thus it can create waste and inefficiencies that don't really do anything for anyone.

you say that public service cannot be delivered by the private sector, but you only have to look at restaurants, cinemas, bus services, taxi firms ,pubs, bars restaurants: all services delivered to the public by the private sector. You could even compare two swimming pools 5 minutes walk from each other: the public sector Cogan leisure centre and the private sector Cardiff International. It costs 40p more to swim in the latter and yet the service provided is so much better than Cogan. In fact, VoGC have announced they intend to outsource the running of Cogan to the operator of Cardiff International.

This very problem that you have that only the public sector can deliver public services is very outdated and really doesn't hold in reality. The more we see the private sector operate public services within a tightly controlled framework, the more we see the tax payer gets better value for money. it is an issue for some on the left that they just cannot accept that a private sector operator can match the service levels of the public sector at a lesser cost to the taxpayer - even whilst factoring in the profit element. The whole purpose of our taxes is to provide public services: the public sector should not have that monopoly as it is not in the taxpayers interest to do so.

Jantra,

I don't know how to put this in any other way, the NHS pension collects more in contributions than it pays out, as a result it returns money to the treasury. That in essence equals a profit, as you call it. Surely in your right wing private sector logic that equates to 'good business'?

Your point of view is equaly based in ideology, the ideology that all public services are inefficiant and wasteful and all private business is magicaly cost effective. It realy gets my back up when people like you generalise and sugest that NHS staff such as me are wasteful, ineficiant, overpaid and have gold plated pensions. I have worked in both the public and private sector and I can say from personal experience that there is just as much waste in both areas.
The private sector has shown time and time again that profits come before all else, the disire to chase money does not automaticaly lead to a more cost effective result to the tax payer. A private company will take the same amount of money from government that the public sector does and then cut everything to make a profit. It realy is very simple.

Lets take this very recent personal experience, goods were ordered from SET (a private company) the wrong products were delivered, goods were re-ordered, SET van arrives with correct order, driver refuses to take incorect product away as 'it's not on my list!' At a later date van comes back to collect origional incorrect order. Not exactly maximising profits and minimising waste!!

Please don't give me the complete nonsence that private companies are somehow devoid of inefficancy and waste, we all see it every day and can list many examples.

As I have said many times I work for the NHS and I can assure you the bureaucracy I have to put up with comes from government and managers that suposedly come from private sector backgrounds, in my particular organisation the executives are ex bankers and fund managers. You really don't see that your stance is equaly ideological and based on a backward and rose-tinted view that private companies are some how the answer to everything.

To use 'restaurants, cinemas, bus services, taxi firms ,pubs, bars restaurants' as an example of public services run by the private sector shows that you don't really understand the concept of the 'services industry' (business) and 'public services'. As I have explained these are all businesses that have a product to sell, therfore creating wealth and jobs. A public service does not sell a product, for example the NHS, we are not a business, we do not make anything or sell anything, we do not create wealth, we help people and look after them. You could argue that the NHS is cost effective in that we help people to stay healthy and keep working so generating wealth for the country, althogh that would be an over simplified generalisation of a very cpmplex public services.

To say that these things are the same and a business is an over simplification of the complexities of a modern society and economy and shows a misplaced ideologidcal point of view that the market has the answer to everything.

I am not advocating a system where the state has a monopoly over everything, I belive in business and wealth creation, I am ulimatley a capatalist, I belive that we should have lower taxes and less government, I also belive that certain public services should not be provided by a private company because thay are incompatable the same as it would be for the state to run everything.

Esentialy Jantra we are not that far apart, I would guess that esentialy we would both like to see the same things but believe that they are achieved in different ways.

it is an unfunded scheme. it is paid for from taxation. this is undeniable. all contributions deducted are paid directly to HMT and not into a pension fund. All pension payments are made from taxes received in the year the payment is made and not from an annuity bought with a pensioners pension fund.

In any given year, contributions deducted may be greater than payments made, but that does not consider the accrued liabilities in any way. A contribution to a pension fund should be paid directly into a pension fund and should not be used to fund someone elses pension. That is a giant legalised PONZI scheme.

you - and others in the public sector - really do fail to understand that when you make contributions, they are not going towards your pension, they are paying someone elses pension today. The payments of your pension will be made from taxation in future years - those who receive pension payments today are receiving payments from taxation. In other words, taxes are being levied today to pay for pensions to people who worked yesterday. it is intergenerational theft.

Before you go any further, please review the Hutton report on public sector pension reform, the Audit Commission on LGPS and the Whole of government accounts 2010. They explain very succinctly how public sector pensions are funded and how - other than the LGPS - they have liabilities but no assets.

just for reference, NHS pensions are funded entirely from taxation. they have no assets and liabilities in excess of £150bn.


I never said that - you did. I said that where the private sector can deliver the same service more cost effectively then it should be used. I am not opposed to public services being delivered by the public sector. I think however that you are opposed to public services being delivered by the private sector.


any organisation that is such a behemoth will be wasteful in terms of resource allocation and utilisation. any such organisation will be slow to respond and have far too many chiefs duplicating effort.


agreed, except when the private sector is wasteful it is not my taxes they are wasting


once again I agree. however, I am not opposed to utilising the private sector - even if it means they make a profit - to deliver services that would ultimately be more cost effective if service levels can be maintained. you automatically assume service levels will fall - but in a tightly controlled regulatory framework there is no need for that to happen. You only need to look at the German healthcare system which is all private sector and is yet miles ahead in terms of patient care and outcomes than the UKs NHS.


that is absolute rubbish. the private sector will look at what needs to be done to deliver the result. It will focus on results and outcomes rather than processes and the box ticking facade that our public service delivery has become. The public sector do not spend taxes as if it was their own money whereas much tighter financial controls exist within the private sector. managing costs downwards most certainly does not mean loss of service. There is always room to trim fat in any organisation whether public or private. The public sector in the UK is very inefficient, certainly whn it is compared to public sectors in other G8 nations.


so next time do you use SET or do you use another provider? with the private sector you have a choice. You have given one example but I'm sure there are countless others where the public sector fails and yet there is no choice to change provider. The private sector, by providing choice, ensures that if their is failure in service provision then the private sector operator is penalised, loses profit and someone better takes their place. If SET were a public sector operator you would have no choice but to use them aain - as it happens, you can pick another supplier and get better service.


please can you show me where I have said any of the above in my posts? I think you must be confusing me with someone else. My position is clear:waste in the public sector is my hard eanred taxes being spunked up the wall. waste in the private sector only affects the shareholders and not me. I care not if they are inefficient and cost ineffective as it impacts them more than me. When the public sector has inefficiencies, it is the taxpayer that foots the bill.


perhaps the bureaucracy comes from the NHS rather than the individuals. i have never heard anyone suggest that bureaucracy is the fault of the individual rather than the organisation - until now.

I've worked in banking and I'll tell you straight that banks do their best to eliminate waste and bureaucracy as much as possible. Waste = cost equals loss of profits. That is the rub.


again I ask that you show me where I have made such a statement? What I have said is that we should not be afraid to engage with the private sector where it is in the best interests of service delivery and cost effectiveness for the taxpayer. I am not opposed to public services being delivered by the public sector, not in the slightest, i am just not so naive to think that the public sector has all the answers. it doesn't.



so if taxis and buses are not public services, why nationalise the trains? I am well aware of what public services are - they are services used by the public. You have a narrow definition based on your ideology that services to the public can only be provided by the state. Services to the public come in many shapes and sizes and not just through the state.



what about the recent policy if the NHS opening up foreign clinics to utilise its skills and sell its services aborad? Would you consider that provision of public services or would you consider that private sector?



I'd argue that it isn't cost effective, not when you consider the outcomes it delivers against its total cost for the nation, not when compared with other more advanced healthcare systems


I am not ideologically driven, I am not the one saying we cannot use a certain sector - you are. I am arguing the case for picking the best sector to deliver a service. in some cases it will be the public sector, in other cases it will be the private sector.

do you think hinchingbrooke has been a disaster thus far with costs being lowered and patient outcomes improving?


good, then you'll see that the private sector can be used - not all the time - but in certain cases.


you will need to consider how public services can be delivered cost effectively with in some cases better service by the private sector in other countries, but here in the UK we have some peopel who refuse to engage with the private sector due to ideological reasons rather than anything else.

I want better public services, I also think that in some cases this can be delivered better by the private sector. if you were told to run 100m you'd run it faster being chased by a hungry lion. The fact is, humans operate better when faced with pressure and constraints. The possibility of losing a contract if (i) costs overrun or (ii) services diminish can focus the business to deliver in a way that the public sector does not have to consider.

I am not advocating all public services run by the private sector, all I am saying is that we should be more open minded to the possibility of engaging when it is in the taxpayers interests to do so. Throwing money at a problem is not the answer and we need to spend our taxes more wisely than ever before.

Gareth

please read this BBC article regarding NHS pensions and how they are funded. No party spin, no union ideology, just the facts:-

BBC article

I draw your attention to this bit

so in other words, the scheme payments are made directly from taxation. members 'contributions' is money that is never actually required by HMT (as it does not need to pay out salary 'gross' before receiving the pension contribution back from the member. thus it lowers the true cost of providing the service for the taxpayer in the year the service is provided, but it increases the costs in future years when the pension payments need to be made.

I was wrong, the NHS schemes don't have liabilities of more than £150bn, they are more like £300bn. with no assets to pay these liabilities, that means taxpayers need to find £300bn in future years - despite you thinking you have made contributions to a pension fund what your contributions have been doing is paying someone else's pension. The shortfall is made up by the taxpayer and with a bill of £300bn and growing each year, it is going to get worse until thankfully this government had the steel to make the changes necessary.

This is also taken from the BBC web site:-

http://www.bbc.co.uk/blogs/thereporters/stephanieflanders/2010/06/some_of_the_truth_about_public.html

I will draw your attention to paragraph 9 in particular.

Home truth no 1: the rise in the "cost" of public-sector pensions, which so excited the deputy prime minister when it appeared in the OBR's report on Monday, has almost nothing to do with the "unfairness" - or their "unaffordability".

The report showed the Treasury cost of public-sector pensions rising from £3.1bn in 2008-9 to £9.4bn in 2014-15. But that - quite literally - is not the half of it.

According to the National Audit Office, the two million-odd people receiving public-sector pensions from one of the four big schemes received £19.3bn in 2008-9. Employee contributions covered £4.4bn of that. The remaining £14.9bn was paid by the taxpayer: of which £12.5bn came from (public-sector) employer contributions and the remaining few billion coming from the Treasury.

The fact that the Treasury cost is due to more than double over the next five years tells you nothing about the future sustainability - or otherwise - of the system. All it tells you is that these are pay-as-you-go schemes: there is no pot of money paid in by workers in the past that can now be put toward paying their pensions.

The money for those payments comes from today's workers. If it turns out that there are more pensions to be paid than there are contributions, the Treasury has to cough up.

One reason why that £3.1bn number is going to go up so fast over the next few years is that there were a lot people who joined the public sector 30-40 years ago who are now retiring. So - pension payments are going up.

The other reason is that the Treasury doesn't think that total contributions by employees and employers are going to rise as they have in the past, because public-sector wages are going to be flat, and the number of people employed by the government is (surely) going to fall.

Mr Clegg said "we cannot ignore a spending area which will more than double within five years." If he wants to bring that figure down dramatically, the best advice to him might be to expand the public-sector workforce and massively increase their pay. In five years' time, public-sector pensions probably wouldn't "cost" the government anything at all. In fact, the Treasury might even be making a profit.

As it happens, this is what happened in the NHS over the past decade - pay and employment shot up. The result was that the "cost" of their pension scheme disappeared. In 2008-9, you might be surprised to hear that the NHS pension scheme ran a big surplus: it paid in £2.1bn more to the Treasury than it paid out.

Does that mean that we can leave the NHS out of this tough-minded review of the cost of public pension schemes? Of course the answer is no, because all of those new NHS employees are getting some big pension promises in return for those contributions, which sooner or later the Treasury is going to have to honour.

There is a need to make public sector pensions work but paying me less and making me poor in retirement to bring me in line with private sector emplyees that choose not to have a pension is not the answer.

hutton clearly defines what is meant by affordable and sustainable - Hutton also makes it clear that public sector pensions are neither. nick Clegg is ideologically opposed to cutting public sector pensions - Clegg is not looking at the economic reality. An accuasation that can be levelled at the left in general.


I'm aware of all that. According to Hutton, £21bn was paid out in 2010, £7bn from contributions, £11bn from employers contributions and £3bn from the taxpayer. It is this £3bn that is the issue.

it also shows that your claim that the schemes are sustainable is also false. i will explain this later, but the public sector pension is a giant ponzi


you have finally understood why these schemes are wrong. The cost of providing the pension should be paid for by the taxpayer who receives the public service in the year it is received. Not the taxpayer who is not yet born, or who has not yet received the service. The pension contribution should have been set aside and put into pension funds to pay out in future years, but when these schemes were set up, governments of all colours used the contributions to ensure that taxes did not have to be so high in those years...using employees pensions contributions to provide services elsewhere. That means the taxpayer received services that are now being paid for by higher taxes today.


no, the taxpayer has to cough up. thayt is unfair. you do realise such schemes are reliant on an ever increasing supply of new members paying in. They are ponzi schemes. when such schemes were found out in the private sector the trustees were often subject to criminal proceedings.


the cost of providing these pensions should have been incurred when the service was being provided and not taken from taxes when the pensions are being paid. Why should someone born today pay taxes in say 18 years time that go towards paying a pension of someone who retired yesterday and never once provided a service whilst the taxpayer was alive. The cost of providing public services should be paid for by those that use the services and not future generations. by making future generations pick up the cost of services we have benefitted from ensures they receive lesser services than we do. that is utterly selfish


great, so acceptance by some it is a ponzi scheme. it is only sustainable if there is a continued supply of new members. Bascially, a pension fund should have been set up so that contributions were invested accordingly. As they weren't, it means that if there are no new members, the schemes collaps. i'm sick of saying it but they really are ponzi schemes.


fcuk me, you could not make it up. the only way we can reduce the cost of public sector pensions is to increase the overall cost of public sector workers giving them much better pay. I really cannot beleive some people would swallow this. Clegg is saying lets save £10 by spending £20. As contributions make up less than 100% of the workers pay (average about 8%), then for the 8% extra contributions on average, its costs the taxpayer 12.5 times as much in finding extra pay. I find it incredulous that some people are so daft as to think this represents good economy. utter madness and if this is the case then it really is time to trim the herd.


what about the liabilitiesw it incurred during the year for the employee contributions? you always ignore that? where is the money coming from to pay those accrued pension benefits? The cost is born by taxpayers in future years - that is, people who were not receipients of the services provided by the public sector in the year the benefit was accrued. I refer back to my claim it is inter generational theft and that is why something must be done.


that is why we need pension reform, because the cost is far too great. we are living longer. When these pensions were set up, average life expectancy beyond retirement was a few years, say about 10% of overall life expectancy. Now average life expectancy is a lot more - in fact, if you were to say that retirement should be for 10% of overall life, most people would need to retire at 72 and not at 60. we are living longer, the government actuaries got that calculation wrong and not enough was set aside prior to this government to cover the cost of the pension. The bill is being paid for by the taxpayer and the current liability is around £1trn. That means that a child born today can expect to pay £18k taxes in his lifetime providing pensions to public sector workers who provided a service before he was even born. That is totally unfair and anyone who says that an unborn child should pick up the bill for previous governments failure to address the issue is utterly selfish and contemptible.


why should you not work longer - just like everyone else. we all contribute to society, not just public sector workers. we are all having to work longer - i expect to work beyond 70 and thats the way it is. i cannot expect to have an extended life of an extra 10 years or so but demand I enjoy the same pension rights as my forefathers. I need to pay more in and contribute more - to say otherwise is totally unreasonable.
in 1960 the average life expectancy may have been 70 with a retirement age of 60. Now the average life expectancy is 80+ but some people think that being retired twice as long as those that went before us incurs no cost - it does. The cost of retirement should be picked up by the pensioner and no one else. They are the recipient of the pension and therefore they should pay for it themselves in full.

Jantra,

In case you missed the blindinly obvious, I have to work for fourty years and to a minimum of 68 before I can have the option take either my state or NHS pension, I'm 33 buy the way so I'll remind you that it is the total incompitance and down righ selfishness of the post war baby boomers that have brought us to this, so as far as I am concerned thay can take the heat and sort out their own fuck up.

I will never be able to afford to own my own home because of the baby boomers obsession with ever increasing property prices, by the time I do get to 68 my pension both state and NHS will be so erroded and small that I will never be able to retire let alone for 10% of my life expectancy. I face a future of work until you drop, low wages and a society that has been brain washed by right wing nut jobs to believe that the public worker is the cause of all evil. For the love of god I go to work every day to help people, not sit in a bank and fuck everyone over, yet according to you I am the devil incarnate and should be paraded on the streets as a focus for public hatered!!!

Don't presume to lecture me about the need to work longer when I see people around me retireing between the age of 50 - 60 with their mortgages payed off after a life of plenty, free university education, low taxes and so on.

out of curiosity - did you actually read Stephanie Flanders' article in full? The message she gets across is quite clearly public sector pensions are the hidden time bomb and that the costs are generally masked from the public due to the payments having to be made over a number of years.

I'm not sure what we are debating here. It is readily understood by all except the unions that reform is needed in public sector pensions, pretty much due to them being funded from taxes and the fact that we are all living longer. it is most certainly not a race to the bottom. when it comes to our retirement it is up to us 'here and now' to save rather than hope that the next generation will continue coughing up the taxes to fund the bill.

I agree with your analysis about the baby boomers. Perhaps you have missed my continued reference to inter generational theft. Perhaps you'll understand my comments that governments of all colours have failed to address this issue and as such the problem has accumulated to where it is today.

You are quite correct that the baby boomer generation are reaping all the benefits whereas the costs are being passed to the younger generations. This is why I want the issue sorted now. I am slightly older than you (37) but I am prepared to take years of austerity if it means my children and their children have a better future. It really does gall to think that my children and my grandchildren could be paying for the pensions of those who retired before they were born who could and should have done something to rectify the issue but were too selfish regarding their own 'entitlements'.

promises were made that were unaffordable. the chickens have come home to roost


i empathise with your points you raise but what do you suggest? keep paying the pensions and keep retiring early only exacerbates the problem for future generations.

regarding your latter point, I don't think anyone to the right believes what you have claimed - just that the UK's public sector is far too big (1m new employees between 1997-2003 with 800k in admin positions rather than front line).

the public sector is essential in the same way the private sector is essential. both should and could coexist if the 19th century view of left and right could be replaced with a more pragmatic approach to politics fit for the 21st century


you're no such thing, stop being paranoid. i have made no comment regarding you or the work you do, just that public sector pensions are unaffordable and need serious reform.


I totally agree with all of that. do you think I do not? I am on your side. however, we differ in that I think we need to make changes now so our children don't suffer the same as we have. life isn't fair, thats for sure. but by ignoring the problem will not make it go away.

Jantra,

You began this thread as 'never trust a politician' and that is exactly my point in not wanting private sector involvement in the NHS, although it has already happened, so my stand is purely accedemic now. Standards in the NHS are falling and everything is driven by money. Personaly I am only permitted to do certain things now because money is attached to it, not because it is what I believe best for those in my care. If it's not a target with a money value I'm not permitted to do it. How exactly is that improving care Jantra?

My point is that the 'right' loves nothing better than to vilify public workers, branding us all lazy and overpaid.

My pay is falling, my pension is slowly becoming worthless, I have to work longer than any other generation past (life expectancy for wealthy middle class people has gone up but for poorer people there has been little improvement). Now there is a movement within the NHS to take two days leave from us, makes us work a longer week and cut pay by 15%. These may appear as small change but on an idavidual level it is utterly demoralising to know that I am paying the price and being portrayed as a drain on society.

Do you realy expect me to be happy about this and say 'ok I'll take the pain' so that the middle classes can continue to enjoy there lovely three bed-semi, two cars a wife and 2.4 children! Get real!! I didn't cause this mess.

As I have said I don't own my own home and never will, I don't have children and never will, I have to live in London to work, where the cost of living is crippleing. My Father died at the age of 57 with enough money to bury him and not much else then my Mother just about manages to get buy and god knows what I'll do if she gets to an age where she needs care!! So yes Jantra life isn't fucking fair, I don't expect it to be but I realy don't think governments should be making it even worse to suit their own agender especialy when a politician pays nothing towards a pension that they get after 'working' for a short period of time. Now that they have fucked me over they can do the same to themselves and cut their own pay by 15% as well.

I agree whole heartedly agree that pensions are a big problem but you appear to miss the point that changes have already been made and the situation is heading in the right direction. Public spending because of pensions will increase slightly as a part of GDP over the next few years as the well endowed baby-boomers retire, but as thay sart to die off and the changes to pensions take hold and the overll numbers of public workers continues to fall (as it already has) public spending as a percentage of GDP will fall back. If you look at it in terms of billions of £'s then of course it looks bad. However equating the economy of a country to that of a household is disingenious and missleading. Without goverment borrowing there are no returns made on guilts and bonds and nothing to fund private sector pensions. And before you start I'm not advocating reckless unfunded spending I am mearly highlighting the need for a balanced and sensible economy not the constant swing from right to left, spend and cut, public and private.

Where I have a problem and call it ideological if you like, is that the private sector is held up in shining light as the example of everything that is right and good in the world and we should all bow down to their superior abilities, give me strength, there are just as many examples of badly run business as there are badly run public departments.

I accept that changes need to be made and that times are hard, but start at the top and lead by example. There has to be a lot of changes before I will be anywhere near believing that the private sector can do things cheaper and/or better, there is little evidence of that and I firmly beieve that as I have said a private company will simply move in, take the same amount of money from the government, slash and burn then call the difference a profit. That is not a profit or cheaper for the tax payer, it is simply lining the pockets of a small number of people with public money. If a private company was going to come along and say well pay you the same but save money by getting rid of government/management waste then I'd be the turkey that votes for christmas, but as it stands I have no confidence in either private business or government. Never Trust a Politician.

i'm not sure i understand why not trusting politicians should mean that we cannot engage the private sector to deliver public services, including healthcare. Healthcare is delivered by the private sector in the UK and when it is deliverd it is done well, certainly at private hospitals. Now i would like all citizens of the UK to receive that level of care and not just those who can afford private healthcare. In Germany, all healthcare is delivered by the private sector and the very richest person is seen by the same doctor or specialist as the very poorest person. That is what I want in the UK. for all its benefits the NHS brings, being totally public sector is an outdated outmoded ideal. We have seen it in other nations. I most certainly do not want a two tier healthcare system and that is exactly what we have in the UK whereas in Germany it is single tier.


thats not true, the right does no such thing. Thost that deliver public services, be it publicly owned or private, perform a necessary service. you've mentioned your age as being 33 and to a certain extent you have always lived your adult life under a leftist Labour government that didn't really think about economics and the costs of providing good public sector salaries, generous benefits and excellent pensions. we have a far more pragmatic coalition government that understands living standards cannot continue to rise if we don't increase productivity and output. Creating 1m extra workers in the public sector - as Labour did - does nothing for the UK economy if all the workers do is purchase iPods and BMWs (ie non UK produce). In my view, the right tend to think more along the lines of living within your means as opposed to borrow and spend with no much thought for the consequences. Since you joined the NHS you would have had a good remuneration package and as such this has eroded in real terms since 2010 - thats not necessarily the fault of the right - more to do with the fact as a nation we can no longer to be as freewheeling with the public purse.


Have you ever considered that prior to 2010, your earnings and benefits were greatly inflated by a Labour government over and above where they should have been on the trend line and now all we are seeing is a return back to where they should be on the trend?

I don't want that to sound flippant as its not meant to be, but Labour inflated public sector pay, benefits and pensions considerably in their time in office over and above average pay inflation. As a result, earnings do need to be checked and that means dropping in real terms back to where they would have been in pay had risen according to average pay increases


if you ever borrowed, if you ever voted Labour, if you spent on credit, then you are part of the systemic problem that created the 2008 financial crisis. you may claim you did not cause the mess, my children certainly did not and I don't see why our generation, who were happy buying two TVs on HP, cars and holidays on credit cards and so on, should not be prepared to take the pain so that the next generation have a better chance than we do. The mess was caused by society: the government for not regulating the system, the people for not wanting to save but wanting everything now and the banks for ignoring credit risk.


politicians have had their pay cut, certainly ministerial pay has been cut. It is one of the first things Cameron did when in office. However, notwithstanding that as I appreciate it is not your point, i am well aware the cost of living is rising whereas earnings are not. See my previous point about returning to the trned line. Its not nice, we had gotten used to a certain standard of living, but that living was based on credit rather than actual output. When you borrow you do have to pay back - the paying back provides a double hit. You no longer have the spending power of the borrowing and you also have even less to spend due to having to pay back what you borrowed.


it only falls as a percentage of GDP if (i) the number of public sector workers falls and (ii) interest rates rise. now following on from your post yesterday where you claimed clegg said we can take increase the numbers of public sector workers to ensure more is continually paid in, this sort of negates the first part. Secondly, rising interest rates would very much cripple the UK at present, with little or no recovery, mortgage payments would take a battering and there would be an increase in repossessions.

The private sector is certainly not the shining light. The banks have to take their fair share of the blame. They were allowed to run amok. The way they have manipulated LIBOR, their propensity to take from the poor at the expense of the rich (bank charges to subsidise free banking), all shows that they don't have their customers at heart. I refer back to my point yesterday about the free market. The consumer does have a choice with the private sector, they do not with the public sector. Banks are slowly realising society want them to clean up their act and the banks are doing so. Consider Fred goodwin, Andy Hornby and bob diamond have all been removed from their posts due to banks wanting to save their reputation. now consider the private sector consultants brought in as full time staff by WG to deliver the GIB bid. The bid was effectively a comic yet the public sector did not feel the need to remove these high end civil servants from their roles unlike the private sector. This is one of the reasons why we need greater private sector involvement - accountability.


being in the NHs have you heard about Hinchingbrooke? it is early days yet but patient outcomes have improved and costs have been maintained. In my view that means the public service is getting better. We need to remember the purpose of public services delivery is to deliver a service to the public and not to create jobs in the public sector.

now with Circle, they can only meet their targets if they can attract patients from other local hospitals. To do this they will need to show the standard of care and patient outcomes is better than the other hospitals. This is how patient care improves. If patient care does not improve and outcomes do not improve, then Circle will not attract more patients to the hospital and they will not make the profits they have forecast. It really is win win. patient care either improves with the cost to the taxpayer not increasing or Circle lose the contract to deliver.

Wow!! Private health care in the UK is generaly provided by doctors that work for both the NHS and private providers, I dispute your point that private health care is 'better' the NHS has and continues to be the best thing this country has ever done. No, it's not perfect, but neither is private health care and neither is the German system. It always staggers me the number of people who are so quick to point out the down sides of the NHS whilst forgetting that no system is perfect. Ultimately the money for health care comes from an indaviduals pocket wheather it is private or through taxes.

I will not defend a Labour goverment but I will also not defend a Tory or coallitian government. Prior to the 2010 election it was the Labour goverment that brought about the Hutton report and began the path that we are on now. Yes they spent way too much and caused this mess but have you considered that in 1997 the NHS was at breaking point and to a certain extent money needed to be invested, admittedly a lot of it was wasted and that is very wrong, there should have been more thought put in to it. This coalitian is not prgmatic in any way, fair enough I agree with you that I have enjoyed an increase in wages but only to a more reasonable level, for some this has pushed them above private sector wages in their area and yes the balance needs to be achieved, I agree with you. My point is this will not be brought about by the private sector being given free fain with public services, the trend is already there. Handing everything over is simply an ideological point of view that the state is a tax collector that hannds over money to private companies to run public services. There is no reason why a public service can't be run by the state in a proper way.

When cameron was elected he cut 5% from a small number of top politicians, small change and a long way to go before their wages are brought into line £60,000 for a junior politician way to much if you ask me, half that would be more like it.

The number of public workers is and will continue to fall and over time interest rates will rise as they are unstastainably low at present, but as the economy improves they will rise.

Yes I have heard about Hinchingbrooke I don't know all of the facts, none of us do. This is one hospital trust with a particular set of circumstanes that have improved. Is this a result of 'privatisation' or could the same have been done within state control with decent management? Most NHS managers come from a private background now, I would point the finger of failier at them not the state and the staff. This is a very complex issue and to hold it up as an example for selling off the NHS is over simplifing the situation. I am happy to learn and improve and do what is needed I just don't see the need to make my terms and conditions worse, punishing the staff for management/government incompitance is not the way forward. There is a link between staff morale and the service provided. that is not to say you have to pay everyone a stupid amount of money but you do need to value your staff and what they do. Hinchingbrook is one isolated case there are many hospital trust that remain within the state, within budget and provide outstanding care and results, the private sector does not hold the answers and you are very wrong to say that there is no accountability in the state cirtainly not from my own professional point of view and it is very unfair of you to say so, I am accountable and responsible for everything that I do and the consequences are very serious.

I explained that rather badly. I certainly did not mean the standard of care by the medical profession would have been different. I was referring to waiting times and the actual quality of hospital equipment, inpatient rooms and so on. I'm pretty sure a doctor working at the Heath in the morning gives his patients the same care as he does at Spire in the afternoon. apologies if I gave the impression that was not the case, that was not my intention.


I wouldn't hand everything over. We are in agreement. But i also think it is possible to utilise the best of both sectors - even on healthcare. I have alluded to the German healthcare system - and whilst is costs about 10% more per annum per capita, the overall system is better with more doctors, nurses and specialists. There are no waiting times at all for any operation...that is something we should aim to achieve. That is not saying the NHS is poor, but it does show what can be achieved by opening up the service to the private sector


you could argue that they really are paid peanuts for the responsibility they have. i do think it was more oa token gesture than anything else, but you cannot claim they have not seen pay fall in real terms.


public sector numbers have to fall, we are way oversubscribed in the UK and Wales in particular, thanks to Labours janet and john approach to stimulating the economy


two points: the early signs of Hinchingbrooke are very good and indicate better patient care and lower costs. so it is good news, albeit early days. In this instance the private sector can make a difference. That is not to say that they would in all hospitals and i'm not advocating the private sector taking over every hospital if the service could not be improved or costs lowered whilst maintaining service levels.

the second point is, there is certainly a case for saying that some in the civil service and public sector cannot be removed no matter how poorly they perform. I cited the example of the GIB (Green Investment Bank) bid submitted by WG. If you had seen it, you'd understand why those who prepared it should do the decent thing and resign. however, there does seem to be a culture in the UK public sector that individuals should not be held responsible for their own failings. The medical profession is more than likely excluded from this as doctors can be - and often are - struck off the register.

any of the Welsh Labour/WG lemmings/apologists like to add comment on this

its certainly dubious...a company based in the tax haven that is guernsey with all its secretive trust law....sounds a bit fishy to me. looks like someone has their nose in the trough.

Yet another reason to do away with that waste of space in the inner Harbour the scoundrels



NB FAO Karl - it may be like a form of Tourettes, but it is valid nonetheless

Jantra,

Just to expand a little on Hinchingbrooke as I mentioned to you before, you ask the right questions and you get the right answers. 'Lies, damn lies and statistics' I think it's called.

On the face of it yes the early signs are positive, but what is behind the figures? Patient satisfaction up? Well if you give people what they want they will say yes, but are they getting what they need? There is a big difference in health care, the patients doesn't always know best, that is what a doctor trains for so long. Also are they focusing on services that are quick fix and high profile as in the case of the joke that is spire where they pick and choose the highly profitable minimal after care operations such as hip replacements. Long term public health goes out of the window because it is qualitative not quantitative, a private provider will want to see quick turn around and maximum profit.

I really do have a lot of professional concerns when it comes to profits in health care, in fact I find it morally repugnant. From my own experience I am finding it harder and harder to work in an NHS that is now run like a business. It is becoming impossible to do anything of true vale for patients because everything is about targets that have to be achieved so the hospital trust can get money from the commissioners/government. I have to sit in front of a computer entering endless amounts of data so that managers can show it to commissioners and get more money, time that I could be spending looking after people. This is a system set up by this joke of a coalition government and by managers brought in from the private sector. This is a situation that is only going to get worse because the commissioners/government are attaching a money vale to specific things regardless of what professionals think and regardless of true public health because it gives a good headline and induces the government to cough up more money. Putting profits into health care is absolutely the worst option for the public, handing over money to private companies will result in the same cost to the tax payer and reduced service for the public so that they can call it a profit. A private company has to make a profit and pay money to executives and shareholders, the only incentive will be to maintain basic services provision that meets government targets to keep the money rolling in. It will be interesting to see and I am sure I have bored you senseless now but I will say I do enjoy listening to your point of view even if I don't necessarily agree.

I thought health was a devolved matter with the NHS in Wales under the control of WG? How can the (UK) coalition Government be to blame for any issues with the NHS in Wales?

@CapItAll
Gareth works in London


@Gareth
I don't find profits morally repugnant. profits are what drives forward economic expansion, allow businesses to reinvest and create new products and improve services.

The needless processes you speak of - well they certainly would not exist within a private sector organisation. Analysing data for the sake of it adds no value unless it is targetted in some way, but I do agree with you we need fewer bureaucrats and accountants and more medical staff. But I say again, there is no issue with profits if it means improvements to outcomes. The German model is a much better system than ours, offering better patient choice, better outcomes and better value for money. It is all privately delivered.

That is the system we need to aim for, albeit within atightly regulated framework which ensures patient outcomes remain at the very forefront of the service

CapItAll,

Sadly I have to live in London now because my partner has no hope of finding work in Wales.

In England the NHS is very different and is controlled by the health secretary who is a Tory member of the coalition government.

Jantra,

This is my point and where I totaly disagree with you. Health care is not a business, we do not make anything or sell anything, we do not create wealth. The overwhelming cost of health care is staffing, we are a labour intensive area, the second biggest cost is the treatments and services provided.

Therefore 'profits' have to be made by cutting either staff or services, whichever is cut it will result in poorer service to patients. You talk of fewer bureaucrats and accountants, this has got worse since this joke of a goverment has taken over and brought in private sector moddles, business practices and private sector managers.

I think you are so blinded by a misguided view that everything is a business and everything can make a profit. You can't make a profit if you don't make/sell something. If you are takinging tax money from the government and using that to run a public services then making a profit is smoke and mirrors, it is not a real business or real profits. It most definatley is not cost effective for the tax payer as the service still costs the same and the tax spend is still the same. The 'profits' come from cutting because ultimatley providing a public service will always cost the same.

I don't find profits in 'true business' moraly repugnat, infact quite the opposite I am happy for business to make as much money as they can because it provides true tax revenue that can be used to provide public services. You only generate wealth by having a rael business that provides goods and products that people want to buy. Your idea that health care can generate a profit is just as based in ideology as me say that everything should be run by the state. Can you not see that?

The German health modle is far from perfect, their spend is higher than ours because the German system is bogged down in expensive litigation between insurance companies, government and idaviduals as to who pays for what and at what point. To costantly only focus on the possitve and ignore the down sides is not helpfull and does not generate a real debate Jantra. There are even examples of patients coming over to the uk to Great Ormond Street because it is a centre of excellence and we can provide something that Germans don't. This is returned by NHS patients going over to Germany to benefit from their doctors. Yes we can learn from the German modle and improve what we do here but your idea that it will be done by introducing a system of 'profits' is not the way to do it. That system has been with us in the NHS for a number of years and patient satisfaction is falling in the UK.

Gareth

Health provision is a service. you can charge for services. Now I am not saying that in a way to suggest that the rich can have better health care than the poor because that is not my position in the slightest. What I mean is that the provision of health services is exactly that - the provision of a service, much in the same way provision of accountancy and tax services. The difference is merely the service delivered.

I am not advocating anything like the US system at all (I'm not saying you have said I've said this). I truly want a system whereby everyone has access to all services at all times and which is free at point of use.

I appreciate there may be shortcomings in the German model but the German model has access to all and is free at point on use with more patient choice. In the UK we do not all have access to the same doctors, the same hospitals and so forth, there is a definite two tier system. Those who have private healthcare can see the same doctor much earlier than someone who is reliant on the NHS. That is unacceptable and keeping the status quo will ensure that remains.

I would like a healthcare service that is free for all where there are no waiting lists and where patient care is very high. At present we do not have that in the UK whereas the Germans do have that - even though it costs around 10% per annum more.

consider the UK patient who has to call his GP where he has to be registered and make an appointment - probably in three weeks time if you are lucky. The the GP refers to a specialist who recommends surgery in 3-6 months time (if you are lucky).

now consider the German model where the patient can walk off the street into any GP of their choosing (picking the GP that provides the best service). If the patient also knows they need to see a specialist they can walk in off hte street without having a GP referral. Any operations are done almost straight away.

Please tell me which you think is the less bureaucratic time consuming model that places patient outcomes ahead of processes and paperwork?

There is nothing wrong with engaging the private sector if patient outcomes improve. You would seemingly prefer to spend more money as long as it was spent by the public sector delivering lesser outcomes than spending less money deliver greater outcomes just because the private sector made a small profit.

In the case of Hinchingrooke, Circle need to provide better quality of services than they do now to make a profit. They can only make a profit if they increase the number of patients at Hinchingbrooke - they can only do they by providing better patient care and experience. The NHS is about the patient and providing good quality care for the patient. As the taxpayer funds the NHS the taxpayer should have the knowledge that the funds are being spent wisely. By engaging the private sector in such a tightly regulated framework can achieve better outcomes for lower cost. Putting ideology to one side, if patient outcomes improve and the cost to the taxpayer is less, then surely that is a good thing?

overspend 1

overspend 2

examples of why there needs to be tighter cost control in the NHS. Clearly, there is not at present and as such services will decline as a result.

Jantra,

In response to :-

consider the UK patient who has to call his GP where he has to be registered and make an appointment - probably in three weeks time if you are lucky. The the GP refers to a specialist who recommends surgery in 3-6 months time (if you are lucky).

now consider the German model where the patient can walk off the street into any GP of their choosing (picking the GP that provides the best service). If the patient also knows they need to see a specialist they can walk in off hte street without having a GP referral. Any operations are done almost straight away.

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There are many and varied reasons why it is benefical to be registered with a gp and not have apurely 'walk in system' but I really can't be bothered to explain them to you.

I don't know when you last went to see a gp or which one you go to, but if you need an appointment you can ring in the morning and get an appointment for that day. If your gp does not offer this level of service then I suggest you move as you are free to do so.

In the uk you can pick a gp prctice you like, within reason of course. Waiting lists for serious conditions ie cancer, cardiac and so on were until very recently very good with almost instant referrals. Now I know there are examples of where this is not the case and I know the uk has much to learn and the NHS is not perfect and strangley enough everyone I work with wants to do as much as possible to provide the best service.

If you do not have a gp in the uk you can go to NHS walk-in centres where you will be seen an treated accordingly. Again these are not perfect and there needs to be more of them.

Also I will remind you that uk gp's are not and never have been part of the NHS, they are private companies that rely on government money and get paid by the state to see NHS patients. That is why there are massive variations in service levels and why it is very hard for the government to standardise. I could sit here and list endless personal experiences of where gp waste huge amounts of money, tax payers money ultimatley.

In short Jantra my personal oppinion is that you are wrong about private sector involvement in the NHS, the evidence I see around me everyday is that adding to the private companies that are now involved will increase the so called post code lottery and regional variations. At the moment there are national standards and requrements for hospital trust, where these are not met there are financial punishments, services taken over by well performing trusts and private sector involvement such as in Hinchingbrooke. Yet we still have huge problems and inequalities. This is reulting in a fragmented and degenerating service. I really don't understand how you believe and expansion of this moddle will improve the NHS the evidence is clear, it will not. Hinchingbrooke is great and is good for the people that live there, sadly there is no evidence to suggest that all private providers would be able to do this any more than the state can. I am sure you will say that they would then loose their bid and it will be taken over by another provider, That is one of the worst situations possible, what about all of the people that suffer a bad service in the mean time. The situation in the NHS at present is dire and it is a result of constant government involvement and the private sector pick and choose mentality.

What I want is a universal healthcare system over the entire uk, stop the pointless devlovemnt national goverments, stop the farming out of services bring everything back under one roof. If you want private providers to come in and take over say hip oerations then fine but they have provide the same services as everyone else in the uk. The reason there is som much variation in the NHS is because of the continued break up and divolvement of services.

Gareth

This is my final say on the matter. It is clear you are ideologically opposed to private sector involvement. You state clearly you mistrust the private sector and believe it morally wrong for businesses to make a profit in the delivery of health provision.

Yet despite your opposition, the anecdotal evidence from Hinchingbrooke (and Germany) indicates that private sector involvement increases patient outcomes and manages costs better. The only real measurable result for health service should be patient outcomes and yet despite the Germans providing a better overall service to the patient you are opposed to this because it is private sector delivered. This is utter madness. Your sole gripe is that there is expensive litigation - this is not something which impacts the patients and the care they receive so as far as I am concerned it is not a factor. The only consideration should be patient care and nothing else.

In my view it is better to have the private sector make a small profit but deliver better services with costs overall being lower than having lesser quality services that cost more being delivered by the state. I am not suggesting that this would always be the outcome, but in the situations where the private sector can deliver better for cheaper (even when factoring in their profit element), then it is a better deal for the taxpayer and the patient.

For reference, Germany spends about 10% per capita more than we do per annum on healthcare, which includes:-

free at point of use for all
10% more doctors
11% more nurses
10% more specialists
inpatients all have their own rooms
up to date medicines
up to date hospitals
no waiting times
better patient choice
and something the NHS does not deliver - social healthcare (ie nursing homes etc)

The Germans started healthcare in the 1880s under Bismarck, it is way ahead of our NHS in terms of productivity and outcomes and it will always remain so as long as we have this ideological view that the state knows best and only the state can provide healthcare.

Finally, your comments about profiteering from the taxpayer is noble, but remember who pays the taxes in the first instance - private enterprise who generate the profits. not only that, consultants often profit from private sector work despite having typically interest free loans of upwards of £250k over their career which never has to be paid back (the true cost of training a doctor). There is little or no moral high ground to be had from a doctor saying the private sector should not profit from health when doctors are trained for free (at the expense of the taxpayer), earn upwards of £100k or more per annum (5 times the national average) and end up with a pension of £50k plus (4 times the national average). Doctors and healthcare professionals provide a valuable service, but so do housebuilders, farmers and lorry drivers who keep up houses, fed and warm. All have a part to play in society and none are a special case.

Just a little note to finish off this very interesting debate.

I am not idealogicaly opposed to private sector involvement, as I have said, maybe I am not as elequant as you and my point has become confused.

I really don't care if the private sector can come in and improve patient care or if that is achieved by the NHS as a public provider, as you say the patient/client is the primary concern. It would be good to remember that up untill 2010/11 patient satisfaction levels with the NHS had never been higher, if Hinchingbrooke can continue to do this then good, but lets not forget all of the hard work done by the NHS prior to circle taking over.

I still find it very difficult to understand why you feel it is ok for tax money to be wasted on expensive litigation just because it doen't impact patient care. Surley your dislike of public sector waste should be extended to everyone in recipt of public money, private or state?

My reservation as I stated is that the private sector has to make a profit and to do that from healthcare makes me feel very uncomftable and concerned that the desire to make money will take over.

Hopefuly there will be the proper controls and standards to ensure that this does not happen, sadly I have little to no confidence in politicians to ensure that this will be done. I guess my fear is that we are heading more in the direction of America rather than Germany.

Ultimatley this is only an accedemic debate because the private sector has been with us in the NHS for some time and in my own area of work there is talk that Virgin will take the commission some time next year.

Many thanks.

I never said I'm happy for that at all. I said I'd rather the German situation than the UK situation, because the Germans achieve so much more with their money than we do. You have even said it yourself that you have meddling bureaucrats who want to measure everything but add little in the way of value to the patient experience. I'd imagine the private sector would spend less on these and more on front line delivery as that is what will - effectively - drive revenue for the private sector.

Jantra,

Apologies, I missunderstood your intend point of view when you said:-

Your sole gripe is that there is expensive litigation - this is not something which impacts the patients and the care they receive so as far as I am concerned it is not a factor. The only consideration should be patient care and nothing else.

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I understood this to be that because the German health system encorages expensive litigation but does not appear to impact patient care it is not a factor when considering who should be awarded tax money to provide a service.

My response was based on your expressed disre to make providers, public or private, accountable for what they spend, something that we can agree on I think.

I'd hardly say in encourages litigation, merely litigation may happen (as it does in the UK)

you are correct, I wish to see better accountability (see my earlier comment about the authors of WG's GIB bid!!!), the two issues are not really related. All I am saying is that the German system, with all its expensive litigation, provides a better service that the UK system. I see nothing wrong with wanting to emulate the German system whereby Mr Rich and Mr Poor see the same doctors at the same time in the same hospitals. That is truly egalitarian and not the two tier system we have in the UK

Jantra,

I have agreed with you that the German health care system does have many possitives to learn from, my efforts heve been to point out that no system/country is perfect and whatever is done there will be negatives. Of which one is the expensive litigation that Germany has to administrate and account for in it health budget. You have agreed that they are not perfect and neither are we, I have agreed that we can learn from them.

I have something for you to think about. Lets for arguments sake say that continued and increased private sector involvement in public services reduce the tax spend on these services.

This will do nothing to tackle the monumental and eye watering amount of overspending commited by politicians (expenses scandle to name but one) unless we take it to the ultimate conclusion that the palace of westminster, and the devolved administrations are 'privatised' as well. Maybe we could have - 'This budget statement is brought to you in partnetships with coca-cola ltd'.

I've been decorating my house and after putting the first coat of emulsion on I decided to surf the web to pass the time. I came across this interesting sounding thread but after reading for a while i went back to watching the paint dry.

There looks to be an interesting documentary on sunday night on BBC Wales about the Welsh economy at 10:35 ( why are bbc wales programmes like this always on so late? ). Already two stories on the news site about it
Carwyn says Welsh firms lack capital to grow

http://www.bbc.co.uk/news/uk-wales-19523542

Admiral chief exec says there are two many regulations in Wales

http://www.bbc.co.uk/news/uk-wales-19517408


Thoughts?

there certainly is capital available to Welsh firms who are prepared to put the time and effort into resourcing it. Carwyn the Caring is not entirely correct when he makes that statement.

One thing el presidente could do is speed up the time it takes for all levels of public sector in Wales to engage in private sector contracts - from the initial contract stage through to the settling of bills. Operating a little more expeditiously may help rather than hinder. I am certainly aware that dealing with the public sector in Wales can be like swimming through treacle at best, and pushing water uphill at worst.

Haven't they just implemented a law in Wales that all new building need to be built with a sprinkler system which would cost a few £K that could certainly be scrapped.

Did anyone watch this then? Very sad the girl up in Blaengarw who couldn't find a job also Carwyn looked very uncomfortable when asked about education in Wales.

today's eassy question is to compare and contrast the following news articles

BBC Wales

BBC UK



I think the above says it all really. Despite UK employment continuing to improve across the spectrum with jobs being created, here in Wales it really is getting worse. Bear in mind that we in Wales rely on the public sector for 1/4 of all jobs and pretty soon a lot more of those jobs will go when the UK government implements round 2 of its cuts to public spending - thus far we have only seen 20% of the proposed cuts.

This indicates that whilst Labour built the UK economy on a base of sand, Welsh Labour didn't bother with even a base of sand. We are too reliant on the public sector and as a quasi socialist state, we have little or no hope as we become ever more reliant on the HMT for our handouts. further evidence to the claim that we would all be better off getting rid of the Senedd.

Why can't we just have 50 MPs who are responsible for devolved matters and can discuss those matters at parliament? why do we need another layer of imbeciles and self serving sycophants and all that goes with it.

Leanne Wood was on Radio 4's today programme earlier today. James Naughtie is one of the less partisan of interviewers and he still managed to make her look quite clueless. She came across as being not very sharp witted, although I appreciate this may not be the case.

Its a good job Bob Humphries or Evan Davies weren't interviewing as life could have been made very uncomfortable indeed.

I also admire her for sticking to green issues, the economy and getting the young working, but I think in these desperate times I think green issues may also need to take second fiddle to the economy.

good grief

we now have taxpayers money being spent on teaching AM's how to ask ministers questions during committee's. You really couldn't make up this sort of public sector nonsense.

I really would have thought that an AM would have been capable of opening their mouths and speaking...what other skills do you need to ask a question?

to those who have questioned my continuing reference to free prescriptions and Welsh Labour - Carwyn the Caring has already made it a Welsh Labour policy for the next election making the subject a key battle ground.

Bethan Jenkins

seems a bit harsh to suspend someone on the basis of an alleged offence. Even if she is guilty, I think most of us would not expect our employers to sack us if we were found guilty of such an offence.

I am not making light of the alleged offence, just that I think this is a bit harsh (and will no doubt get the children politicians making all sorts of cheap political gain from it.

Is it 'an alleged offence'? She has admitted it albeit trying to blame 'medical reasons'. There is only one reason.....too much alcohol!

It has to be said...."Don't Drink and Drive". Simple!