Yes or No to privatisation of Education and Health?

[raphael123]

What do people think?

Yes or No to privatisation of Education and Health? :)

[tinchote]

I think that it is not a yes/no questions. There are both pros and cons, and it is hard to find a balance.

[tinchote]

I think that it is not a yes/no questions. There are both pros and cons, and it is hard to find a balance.

[BrentJackson]

Education no way.

Healthcare depends on the circumstances.

[LotusElise]

No to both.
People's need to access healthcare and education does not normally increase in line with their income!

[ArrowsFA1]

Neither are "assets" to be sold to the highest bidder, they are services to be run in the interests of the nation as a whole.

[Alexamateo]

For education, I am in favor of the system used in Belgium, public money attaches to the child, and parents are free to send to any accredited school, religious, secular or government run. The way it is now, if you happen to live in a bad school district, tough luck, because you have no choice, nor are there vouchers availible even though you've paid taxes for years. It's not good not to have a choice in education.

[Brown, Jon Brow]

NO WAY

[slinkster]

I say no to both as well... and I think people have already hit the nail on the head as to why.

[BDunnell]

I'm dead against it. Very often, the companies that make the highest bids are not the most competent at running the services, as constant problems with contractors such as Capita, Balfour Beatty and the like demonstrate. Nonetheless, they keep on getting government contracts.

[tinchote]

People are very absolute in their opinions here.

When you go to a public hospital and there are mosquitoes flying and cockroaches walking over the bed where you are supposed to sit on; when they give your kid a bed in a room with another 20, including some with infectious diseases, you start having second thoughts about your principles.

When you go to a university where trash in sitting in the hallways, and you cannot use the washrooms because they are so dirty, and you have take classes in a room that is falling apart, together with another 1000 students in that same room (with sits for maybe half of them), you start having second thoughts about it.

When the public elementary school has a strike during almost half a year, and the kids are not given the lost classes back, you start having second thoughts about it.

When in that same school (and university and hospital for that matter) the salaries don't allow teachers, professors, and physicians to make a decent living, and there are strikes several weeks a year, you start having seconds thoughts about it.

I'm not a particular fan of private education and/or health (and in fact I work at a public university, and take my daughters to a public hospital), but I don't think it is a yes/no question.

[Tomi]

I say no also to both, we have public school, and been in top twice in a row in the OECD PISA test.
Also the health care works quite good.

[BrentJackson]

People are very absolute in their opinions here.

When you go to a public hospital and there are mosquitoes flying and cockroaches walking over the bed where you are supposed to sit on; when they give your kid a bed in a room with another 20, including some with infectious diseases, you start having second thoughts about your principles.

When you go to a university where trash in sitting in the hallways, and you cannot use the washrooms because they are so dirty, and you have take classes in a room that is falling apart, together with another 1000 students in that same room (with sits for maybe half of them), you start having second thoughts about it.

When the public elementary school has a strike during almost half a year, and the kids are not given the lost classes back, you start having second thoughts about it.

When in that same school (and university and hospital for that matter) the salaries don't allow teachers, professors, and physicians to make a decent living, and there are strikes several weeks a year, you start having seconds thoughts about it.

I'm not a particular fan of private education and/or health (and in fact I work at a public university, and take my daughters to a public hospital), but I don't think it is a yes/no question.

Is that the case in Argentina?

Because up here, and even in semi-developed countries like South Africa, Turkey and parts of India, good education is universal and the country works hard to achieve it. (IIRC, South Africa's schools are better than that of the USA. :eek: ) Here (and probably in many developing countries) private schools would end up indoctrination centers more than anything else.

Such systems are made with the purpose of serving society, not making profits. Keep them in the public sector.

[tinchote]

Is that the case in Argentina?

Because up here, and even in semi-developed countries like South Africa, Turkey and parts of India, good education is universal and the country works hard to achieve it. (IIRC, South Africa's schools are better than that of the USA. :eek: ) Here (and probably in many developing countries) private schools would end up indoctrination centers more than anything else.

Such systems are made with the purpose of serving society, not making profits. Keep them in the public sector.

It is the case in Argentina. With a few exceptions, but in general you find what I describe.

The quality of both physicians and educators in Argentina is probably better than in North America (as far as we can tell; every time we have an issue with the girls in Canada we end up getting the right answers in Argentina, even though hospitals have far less resources). Workers have to pay a (not significant) mandatory percentage to their unions for health care, and so most workers have access to private health care.

The biggest public universities in Argentina will certainly give better education than their North American counterparts. But you still have to walk through the trash.

Now, in Canada, you cannot tell a private University from a public one, unless you look really deep into it. And the same applies to health care.

So, in the end, in my opinion it is the responsibility of the public sector that the population has access to education and health care, but that doesn't necessarilly mean that the state has to implement the concrete facilities.

[schmenke]

Canada is a very good example of how a public health care system just doesn't work. Waiting several hours in a hospital or clinic to see a doctor is the norm. Wait times for surgery can be several months!

There were a couple of recent incidences here in the province of Alberta, where a pregnant mother had to be rushed by plane to a hospital across the border in Montana for emergency aid because no facility here could accommodate her.
http://www.canada.com/calgaryherald/news/story.html?id=006b4771-7e97-4468-a03d-00ec94761de9&p=1

Our health care system is embarassing :down:
The purpose of a health care system is to provide quality, efficient treatment. This simply is not happening. In fact it's just the opposite, people are getting sicker while they wait for treatment :s

Give me private, or at the very least, a "two-tier" system. Everyone will then benefit.

[CarlMetro]

In the UK we have a choice, either to pay for private or to use public funded state run services. It comes down to the same old story of you get what you pay for.

I choose private health over the NHS because of a much higher standard of care, better response times etc. I would choose private schools over state for my son too, purely because the standards taught are better than in the majority of state run schools. However I am fortunate to be able to pay the costs involved and they are not cheap.

I would like to see tax breaks for those, like myself, who opt-out of public funded services. This may then make it more affordable for more people to take advantage of private services.

However there will always be a need for healthcare for those who cannot afford even the basic private cover and as such the NHS must always remain in some capacity in the UK.

[Rollo]

I'm all for privatising the health care system and my American experience proves it.

A friend of mine was over there and his appendix was about to go nasty. We took him to a hospital with what was obviously an emergency and they wanted to know about medical insurance.
Of course coming from Australia where we do complain about the health care system but don't happen to need it, we just expected that an emergency case would be looked at.

WRONG.
No insurance, they didn't want to know. Foreigners, they didn't want to know. He flew back to Australia the next and had his appendix removed.

<cynical mode>
Obviously the system works perfectly. Anything that kills poor people who comparitavely pay more of a tax burden because they can't hire accountants to give them tax breaks or set up trust accounts - the same people who work in manufacturing and service industries who actually DO THE WORK of the economy rather than sponges in management, should be turned away.

Poor people can't afford medical services, so it obviously implies that they are not worth enough to warrant giving them. Privatise everything, rich people are a better class of people!</cynical mode>

[DonnieDarco]

No to both.

[Bebee]

No. Adequate eduation and health-care should be something everyone has a right to.

Rollo's argument is the exact reason why I'd say no.

Schmenke, we have the same problem here. However, the long waiting lists (for elective, and procedures which aren't urgent) and queues at A & E to an extent isn't the Government's fault. Although, I must admit that even though we complain about our system, we're still miles ahead of the States.

I have private health care, but the only good thing about it is that my dental and particularly, my optical needs are taken care of. The one time I was in hospital (a private one, too), I thought it was absolutely appauling - especially when it came to patient care. From our experience, I've found that the medical staff at public hospitals are generally more experienced and much more competent than those working at private hospitals.

According to my Dad, the old system (pre-Medicare) worked best and he still thinks that's the answer to our failing system.

As for education, the thing that ****s me here is the fact that private schools do get funds from the Government (some more so then public schools). If people choose to send their kids to private schools, that's their choice but I don't see why the Government should be making it more 'affordable' at the hands of stripping everything from public schools.

[LeonBrooke]

Absolutely no to both. Public systems aren't perfect, because nothing ever will be, but they could only get worse in the hands of corporate interests. People seem to think that if they have to wait for an hour at the emergency department then the government is at fault and the problem would be solved by handing it over to business. It definitely would get worse.

[ShiftingGears]

NO and NO.

[raphael123]

I actually agree that the health system and education system shouldn't be privatised, and in particular the education system. Maybe I'm being a Marxist here, but I disagreed with CarlMetro opinion that if you are in the private health sector, you shouldn't pay tax which goes towards the NHS (in the UK). If I've misunderstood that, please forgive me, and feel free to correct me.

The reason I don't agree with it is because obviously very little thought has been put into that arguement, and it simply wouldn't work. The higher earners in this country are the people who would go into the private sector, but they are also the people, due to earning more, pay more taxs. Therefore if you exclude these people from paying tax towards the NHS or any other state service, you are reducing the budget of the e.g. NHS to a great extent.

Plus there are more working class people who wouldn't go private (not through choice), than the high earners of this country who would go private, so the arguement that there would be less demand on the NHS, though is valid, wouldn't be enough to mean the cuts in the NHS budget would be in proportion to the number of people who need it, therefore the NHS would be even less efficience, and have more strain put on it than ever before.

[raphael123]

However, even though I disagree with the privatisation of the NHS, or even the education, there are some very good arguements which would suggest otherwise. Whether it would work in practice is debateble, but in theory it would make sense. So I'll make the case for Yes to privatisation, as simply no one has actually said yes and backed it up.

We want the best service possible, free at the point of delivery, so who cares about who provides the care? It is regressive to think in the terms that getting private companies into the NHS is bad and they are going to screw it over - that is not always the case, most businesses try to simply break even, and are not as profit orienatated as people seem to think. We need cheaper, better drugs, if the private sector make them then why not buy them? If the NHS cleaners do a bad job then why not hire a private company who provide you with a service who you can get rid of them if they don't do a good job.

I think the main reason why people argue against privatisation is because they think all they care is about making a profit. However the fact is that everyone who is involved with running the NHS make money out of it, that's why it costs £100 billion. People have to build hospitals, buy drugs, buy machines, buy beds, buy food etc, the people who provide this service are all doing it for a price, and not out the goodness of their hearts.

What do you guys think? As long as it works and is efficience, who actually cares where it comes from? In theory internal marketisation makes sense and would be more efficience. But in practice I'm not sure it would work, which is why I think it's best to say no to privatisation, but it's always good to keep an open mind on these things :) I look forward to hearing people's opinion on the other side of the arguement :)

[LotusElise]

Healthcare and education are not businesses. Trying to run them like businesses does not work - the aims are too different.

If the aims of both are equal access to services as they are needed, by those who need them most, then introducing market values makes no sense whatsoever. We should be maintaining a good standard across the board instead of arguing for choice and competition.
When I last had to go into hsopital (dodgy wisdom tooth extraction) I did not want to shop around; I just wanted to be treated appropriately at my local hospital. It did mean a wait, but that is an inevitable consequence when insurance worries prevent dentists from performing procedures they are trained for and often experienced in. I accepted that a maxillofacial surgeon has more important patients to see, such as those with cancer and serious facial injuries.
Having said that, when I did see the surgeon, he did an excellent job.

[BDunnell]

I would like to see tax breaks for those, like myself, who opt-out of public funded services. This may then make it more affordable for more people to take advantage of private services.

And thereby encourage more people to opt out of public services, giving less incentive to fund them properly and allowing them to be run down.

Speaking personally, if I was somehow to become a father, I would never remove my child from the state education sector, no matter how much money I had in the bank. I think it's really important that state education be allowed to improve, and a big part of that should come from parents pushing for improvements if they don't think things are good enough, rather than just giving up on the state sector and paying for something 'better'. I use inverted commas because I don't think the private education sector is necessarily automatically better.

[BDunnell]

We want the best service possible, free at the point of delivery, so who cares about who provides the care? It is regressive to think in the terms that getting private companies into the NHS is bad and they are going to screw it over - that is not always the case, most businesses try to simply break even, and are not as profit orienatated as people seem to think. We need cheaper, better drugs, if the private sector make them then why not buy them? If the NHS cleaners do a bad job then why not hire a private company who provide you with a service who you can get rid of them if they don't do a good job.

I think the main reason why people argue against privatisation is because they think all they care is about making a profit. However the fact is that everyone who is involved with running the NHS make money out of it, that's why it costs £100 billion. People have to build hospitals, buy drugs, buy machines, buy beds, buy food etc, the people who provide this service are all doing it for a price, and not out the goodness of their hearts.

I care who provides the service. Privatisation of public services has inevitably allowed huge companies to take on tasks like NHS cleaning, provision of school and hospital meals, major building projects and so on. These companies end up virtually monopolising all big contracts, which offers little incentive for them to do the best job possible. There may also be ethical issues with some of the firms in question — I have a big problem with Balfour Beatty being involved in PFI contracts, for example, on ethical grounds.

Politicians of all the major parties, all of which now feel that private sector involvement in the public services is a good thing, seem to have a rather naive view of the companies involved. They ignore the fact that the first duty of these firms, understandably, is always going to be to their shareholders. This is no way to get the best deal for public service provision.

This is one of my biggest current bugbears about the state of British politics. Politicians of almost all parties go on and on about the benefits of 'choice', yet I as a voter do not have the choice of voting for a major mainstream party which is against private sector involvement in the public services.

[raphael123]

Healthcare and education are not businesses. Trying to run them like businesses does not work - the aims are too different.

If the aims of both are equal access to services as they are needed, by those who need them most, then introducing market values makes no sense whatsoever. We should be maintaining a good standard across the board instead of arguing for choice and competition.
When I last had to go into hsopital (dodgy wisdom tooth extraction) I did not want to shop around; I just wanted to be treated appropriately at my local hospital. It did mean a wait, but that is an inevitable consequence when insurance worries prevent dentists from performing procedures they are trained for and often experienced in. I accepted that a maxillofacial surgeon has more important patients to see, such as those with cancer and serious facial injuries.
Having said that, when I did see the surgeon, he did an excellent job.


But surely in theory, if there is another company who can provide you a better more efficient service, for a better price (allowing you to spend money on other needs), it would be better all round? I know this may sound silly, but just like in F1 where competition brings the best out of a driver, why not use competition to improve the services? When there are no alternatives, it can result in complacency.

Then referring to your trip to your hospital - 'When I last had to go into hsopital I did not want to shop around; I just wanted to be treated appropriately at my local hospital'. Out of interest, does this also apply to education. Would you not 'shop around' to find the best school for your child? Or would you send them to the nearest school near you, even if it had a poor reputation for teaching? Do you not think people should have 'choice'?

BDunnell - I agree with you. Regarding the NHS anyway. The Education system is another matter. I don't think those who send their children to private schools should pay less tax to contribute to state schools, however if I had the means, I wouldn't hesitate about sending my child to one. Why would I deny my child a better opportunity in life? It'd be selfish on my part. I don't see how sending a child of mine to a state school will allow them to improve. Can you explain to me why you think that? All it does is increase overcrowding in classrooms.

As long as people who send their children to private schools don't have to pay less tax than if they didn't, I don't see any problem with sending a child to a private school, and am baffled why sending your child to a state school would allow them to get better? Be nice if you explained that to me :)

[BDunnell]

BDunnell - I agree with you. Regarding the NHS anyway. The Education system is another matter. I don't think those who send their children to private schools should pay less tax to contribute to state schools, however if I had the means, I wouldn't hesitate about sending my child to one. Why would I deny my child a better opportunity in life? It'd be selfish on my part. I don't see how sending a child of mine to a state school will allow them to improve. Can you explain to me why you think that? All it does is increase overcrowding in classrooms.

As long as people who send their children to private schools don't have to pay less tax than if they didn't, I don't see any problem with sending a child to a private school, and am baffled why sending your child to a state school would allow them to get better? Be nice if you explained that to me :)

Because my experience of state schools was perfectly good. I don't believe I'm any less intelligent as a result of having gone to state schools, and the same goes for many people around the country. Therefore, I would have no hesitation in sending my child to a state school, and wouldn't feel that I was a bad parent for doing so even if I had the money to send him or her to a private establishment.

[CarlMetro]

And thereby encourage more people to opt out of public services, giving less incentive to fund them properly and allowing them to be run down.

No, reducing the work load of an already over-run and under-funded public health system, and therefore freeing up resources for those who need it. I'm quite happy to pay for my health care but why should I pay for yours and everyone else's too?

As for education? Both of my brother-in-laws are teachers. Both are head of department. One teaches English at a state school and the other history at a private school. The basic philosophies behind the two schools could not be more different.

The state school is interested in one thing, exam results. The teachers there teach the national curriculum and nothing else. Their whole aim it to get the children to pass their exams with the highest possible margin.

The public school has a different view. Whilst its teachers use the national curriculum as a basis for teaching, they are far more interested in give the child an education rather than making sure they pass their exams.

I would rather my son come away from school with a good education than with a hatful of exam passes. Exam passes are all well and good, they help you progress in certain careers/university etc, but I have always viewed them as more of an indicator of the performance of a person on a single day, not throughout their school life.

[raphael123]

BDunnell, that's more than fair enough, even if I disagree. Going to a private school gives you better opportunities in life - it's a fact! Not necessarily in what you achieve in your exams, or your intelligence, but life experiences. I went to a state school, a lot of my uni friends went to a private school, and have had so much more life experiences. But anyway, you haven't answered my question, how by doing putting your child in a state school, is that allowing state schools to get better?

I look forward to you explaining it :)

[BDunnell]

No, reducing the work load of an already over-run and under-funded public health system, and therefore freeing up resources for those who need it. I'm quite happy to pay for my health care but why should I pay for yours and everyone else's too?

I think that's a highly selfish view to take. It's for the benefit of the greater population. I am very happy to pay taxes towards the healthcare of other people, and so should everybody be.


As for education? Both of my brother-in-laws are teachers. Both are head of department. One teaches English at a state school and the other history at a private school. The basic philosophies behind the two schools could not be more different.

The state school is interested in one thing, exam results. The teachers there teach the national curriculum and nothing else. Their whole aim it to get the children to pass their exams with the highest possible margin.

The public school has a different view. Whilst its teachers use the national curriculum as a basis for teaching, they are far more interested in give the child an education rather than making sure they pass their exams.

I would rather my son come away from school with a good education than with a hatful of exam passes. Exam passes are all well and good, they help you progress in certain careers/university etc, but I have always viewed them as more of an indicator of the performance of a person on a single day, not throughout their school life.

I agree with your view of exams, but you seem to be suggesting that it is impossible for anyone to emerge from the state system with anything other than a load of exam passes. I find that rather patronising towards everybody who's been through the state system and done very well nonetheless.

[BDunnell]

BDunnell, that's more than fair enough, even if I disagree. Going to a private school gives you better opportunities in life - it's a fact! Not necessarily in what you achieve in your exams, or your intelligence, but life experiences. I went to a state school, a lot of my uni friends went to a private school, and have had so much more life experiences.

I disagree with that perception. Another reason people who go to private schools can do better is because of snobbery on the part of some employers, who assume that because someone went to a better school than someone else who has the same qualifications and relevant experience, they are automatically better. Let's not forget that. It still happens.


But anyway, you haven't answered my question, how by doing putting your child in a state school, is that allowing state schools to get better?

I look forward to you explaining it :)

I feel that parents who opt out of state education are in effect giving up on it. If this happens in increasing numbers, it doesn't encourage investment in the state system. I believe passionately in state education, because we ought to have a system like those in so many European countries from which there is no need to opt out, because it's seen as being good enough for (almost) everyone. If I ever become a parent, as I said, I don't think I would be in any way irresponsible if I sent my child to a state school rather than a private one.

[CarlMetro]

I think that's a highly selfish view to take. It's for the benefit of the greater population. I am very happy to pay taxes towards the healthcare of other people, and so should everybody be..

Yes, your are correct, it is very selfish. I want what's best for my family and myself, pretty much like every other person on this planet. And yes, I object to paying for something I do not use.


I agree with your view of exams, but you seem to be suggesting that it is impossible for anyone to emerge from the state system with anything other than a load of exam passes. I find that rather patronising towards everybody who's been through the state system and done very well nonetheless.

I am a product of a state school, as are the vast majority of people I know. Sadly the state education system has changed over the last twenty years to a point where the only things of interest to a head teacher is the position of his/her school in the league tables and their OFSTED report. With the way the national curriculum has progressed over recent times, since the introduction of league tables, the whole emphasis is placed on teaching a child what they need to know, and only that, to pass their exams. There is no time for creative teaching, no space to expand on a certain part of the subject past what is required knowledge to pass an exam. This certainly wasn't the case when I was at school, nor is it the case in my brother-in-laws private school.

Yes a private school also aims for examination passes, and they achieve them too, partly because they pay their teachers more and attract a better level of teacher for it.

[LotusElise]

But surely in theory, if there is another company who can provide you a better more efficient service, for a better price (allowing you to spend money on other needs), it would be better all round? I know this may sound silly, but just like in F1 where competition brings the best out of a driver, why not use competition to improve the services? When there are no alternatives, it can result in complacency.


It doesn't though, does it? Competition in other privatised services has not raised standards. All it has done is pushed providers into cutting costs to maximise their profits. At best, services remain the same, at worst, quality slips in favour of profiteering, ususally thinly disguised as "efficiency".

My point is that we shouldn't need "choice", we should be making sure that services ALL run to a high standard. The introduction of choice does nothing to help this cause and tends to worsen inequality of service.
We must also remember that for many people, there is no choice. They are compelled by their circumstances (poverty, disability, caring for a family member) to accept whichever is nearest and quickest. These are the people who often need good-quality services most, too.

[BDunnell]

Yes, your are correct, it is very selfish. I want what's best for my family and myself, pretty much like every other person on this planet. And yes, I object to paying for something I do not use.

If everyone took that attitude towards taxation, and people were allowed to opt out, the public services in the UK would soon collapse. But clearly this wouldn't worry you.

[BDunnell]

It doesn't though, does it? Competition in other privatised services has not raised standards. All it has done is pushed providers into cutting costs to maximise their profits. At best, services remain the same, at worst, quality slips in favour of profiteering, ususally thinly disguised as "efficiency".

My point is that we shouldn't need "choice", we should be making sure that services ALL run to a high standard. The introduction of choice does nothing to help this cause and tends to worsen inequality of service.
We must also remember that for many people, there is no choice. They are compelled by their circumstances (poverty, disability, caring for a family member) to accept whichever is nearest and quickest. These are the people who often need good-quality services most, too.

I agree with every word of that.

[raphael123]

BDunnell


I think that's a highly selfish view to take. It's for the benefit of the greater population. I am very happy to pay taxes towards the healthcare of other people, and so should everybody be.

BDunnell, I agree with you. CarlMetro attitude is a selfish attitude. I can understand where he is coming from, why should he pay for something he doesn't intend to use. However as long as he realises his idea of only those who intend to use the NHS pay towards it knows that it's not possible, and would leave the NHS under more pressure it's fine.

I remember doing a subject a while back, about whether smokers should get free NHS treatment when it is self inflicted.

I think if CarlMetro was really unhappy about it he would move countries, but the benefits obviously outweigh the negatives :)


I disagree with that perception. Another reason people who go to private schools can do better is because of snobbery on the part of some employers, who assume that because someone went to a better school than someone else who has the same qualifications and relevant experience, they are automatically better. Let's not forget that. It still happens.


Back to schools - it doesn't matter why the reason that private educated children have a better standard of living. I was discussing the fact that they do, because you seemed to think state schools provide children enter the adult world on equal par with those from private schools. You seem to have accepted sending your children to a private school gives you better life opportunities from that quote above, regardless of the reasons for it, and whether its right or wrong :)


I feel that parents who opt out of state education are in effect giving up on it. If this happens in increasing numbers, it doesn't encourage investment in the state system. I believe passionately in state education, because we ought to have a system like those in so many European countries from which there is no need to opt out, because it's seen as being good enough for (almost) everyone. If I ever become a parent, as I said, I don't think I would be in any way irresponsible if I sent my child to a state school rather than a private one.

Private schools shall always exist, whoever is in government. And the large majority of children will go to a state school, that will never change either. Therefore it shall always be one of the core subjects that the government will focus on, and spend a large quantity of their budget on. As long as private educated children parents continue to pay the same amount of tax as they would if their child was in a state school, funding based on whether you send your child to a state or private school will not differ. So I don't think your arguement of by sending your child to a state school will allow state schools to improve makes any sense. If anything it will increase class overcrowding, and the budget will be even more strained than if they went to a private school. Also you wouldn't be irresponsible by sending your child to a state school. I don't think anyone has said that :)

LotusElise

I accept your arguement. In a perfect world we wouldn't need choice. But we don't. With the education system being deemed a failure and failing, same with the NHS, is it time to try privatisation? Afterall, what would you do in the school question I asked you, which you failed to answer?

PS: I'd just like to point out I'd answer No to privatisation in education and the health system, but no one made an arguement for saying yes, and I think there are some valid points to be discussed. Why worry about who provides you the service, as long as its of a good quality.

[LotusElise]

Other privatised services in the UK are still in a mess, so no - it's not time to try privatisation. It doesn't work.

As for the schools question, I don't have children, don't wish to have any and due to my chosen career path am unlikely to be able to afford private education, should I find myself with a child. Therefore, my opinion is purely hypothetical and I'm still going with No.
Carl has made the point that education was much less exam-focused and more "rounded" when he was at school and schools were not run by private companies then. Problems with schooling are more down to poor management and "initiatives" than straight money trouble.

[CarlMetro]

I believe there will always be a place for state run schools and for the NHS. There will always be those who, like Ben, not matter how much money they have will choose state over private and there are always going to be a lot of people who cannot afford to go private in health or education.

The last thing either the current state education system or the NHS need is to be run by a 'for profit' private company. Too many corners would be cut and the quality of both would deteriate, not improve.

I am happy that we have a choice in this country to do state or go private in both. I'm slightly less happy that I still have to pay for services that I do not use but I have no choice but to pay my taxes. I veiw it similar to residents in a local town to me having to purchase parking permits even if they don't park their cars on on the roads or indeed have a car in the first place.

[raphael123]

Interesting...so ok, privatisation is clearly wrong- it would mean all hospitals are run with a mind to keeping costs down, and that income becomes a concern, because they no longer have a reliable and set source of income. Also, in places with few people where they can make less money, they would be likely to close.

You would have a system of health Insurance- where people make costly payments themselves- and clearly this would be a disaster for the majority of poorer or lower income families. Look at America, where they spend 12% of their GDP on heath, compared to 8% in Britain, but ours is better because everyone has access to it. Also an Insurance system is more expensive because not all Government revenue comes from taxes, and so health is subsidised by other revenue- which would not happen under private health.

What about Internal Markets which are entirely different. Internal markets are getting the positive aspects of markets into healthcare. It means that rather than the NHS doing everything like cleaning, logistics, food, building etc. Private companies are hired to do them, because they are cheaper and more efficient. Detractors say that you won't get the same quality of care, and because they are private, profit making companies they will cut corners to cut costs. In reality, the NHS will go for the one which offers best service, which is likely to be more expensive than the market rate, but still cheaper than the NHS doing it.

The Argument behind that is that there is no motivation for the NHS to be efficient- it has vast revenues set years in advance, it is impossible to sack people, so no one works thinking that if they arent good enough then they will lose thier job like you do in private industry.

You can always make the comparison between Soviet and western cars- because in the west, there is a market and competition for cars, the designers had to keep making better ones to maintain thier grip on the market. in the Soviet union they were driving the same cars in 1990 that they were in 1950 because there was no incentive to improve them- everyone worked for the Government and knew they wouldnt be sacked and lived in a comfort zone.

[BDunnell]

What about Internal Markets which are entirely different. Internal markets are getting the positive aspects of markets into healthcare. It means that rather than the NHS doing everything like cleaning, logistics, food, building etc. Private companies are hired to do them, because they are cheaper and more efficient. Detractors say that you won't get the same quality of care, and because they are private, profit making companies they will cut corners to cut costs. In reality, the NHS will go for the one which offers best service, which is likely to be more expensive than the market rate, but still cheaper than the NHS doing it.

There is plenty of evidence to suggest that this has proved to be a failure, largely because of the view that you can just let the private firms in question get on with their jobs without much interference. The British government has constantly failed to take poorly-performing private contractors and service providers to task.

[LotusElise]

One word: MRSA.

[Bebee]

As for education? Both of my brother-in-laws are teachers. Both are head of department. One teaches English at a state school and the other history at a private school. The basic philosophies behind the two schools could not be more different.

The state school is interested in one thing, exam results. The teachers there teach the national curriculum and nothing else. Their whole aim it to get the children to pass their exams with the highest possible margin.

The public school has a different view. Whilst its teachers use the national curriculum as a basis for teaching, they are far more interested in give the child an education rather than making sure they pass their exams.

I would rather my son come away from school with a good education than with a hatful of exam passes. Exam passes are all well and good, they help you progress in certain careers/university etc, but I have always viewed them as more of an indicator of the performance of a person on a single day, not throughout their school life.

I went to a public school, and now I'm in my second year of a PhD with a full scholarship.

From my experience in undergrad, I've found that most of the students came from private schools, and very few from public schools. However, I also found that about 60% of the students from private schools would either drop out or just disappear before the next year. The only reason I could think of which would account for this (because I find that 60% is too high to account for "exceptional circumstances or this is not what I want to do") is that students in private schools are spoon-fed, and 'chased after' - which basically is the way schools try to increase their exam scores = more students. On the other hand, my teachers made it clear from the start of the senior years: "it's your responsibility to do the work, we're just here to support you and help you whenever you want our assistance."

[BDunnell]

I went to a public school, and now I'm in my second year of a PhD with a full scholarship.

From my experience in undergrad, I've found that most of the students came from private schools, and very few from public schools. However, I also found that about 60% of the students from private schools would either drop out or just disappear before the next year. The only reason I could think of which would account for this (because I find that 60% is too high to account for "exceptional circumstances or this is not what I want to do") is that students in private schools are spoon-fed, and 'chased after' - which basically is the way schools try to increase their exam scores = more students. On the other hand, my teachers made it clear from the start of the senior years: "it's your responsibility to do the work, we're just here to support you and help you whenever you want our assistance."

Forgive me, but are you referring to public schools and private schools as the two different forms of private education, or to public schools in the US sense of state schools?

[Caroline]

BDunnell, that's more than fair enough, even if I disagree. Going to a private school gives you better opportunities in life - it's a fact! Not necessarily in what you achieve in your exams, or your intelligence, but life experiences. I went to a state school, a lot of my uni friends went to a private school, and have had so much more life experiences. But anyway, you haven't answered my question, how by doing putting your child in a state school, is that allowing state schools to get better?

I look forward to you explaining it :)

I am not in total agreement about a private school education giving you a fuller life. Life experience is about more than just the time spent in school between 8am and 4pm. I had always believed that a private education was 'better' and in some respects it is but I think if I had a child I would send him/her to the local primary school. I just think that they would get a more well rounded view of the world. Having taught in both private and state schools I can see the advantages to both though. Perhaps it is the parents with a bit extra cash that can afford to take their children travelling etc that leads them to more life experiences.

The private school I taught in had small classes (all girls), enough classroom resources for all, plenty of space and excellent test results. However, the pupils didn't seem worldly, had enough of narrow view (probably instilled from their parents) to think that they were better than the other kids in schools in the area. As far as the teaching standards went I think it was fair to say that they were no better or worse than any state school I know. My present school is pretty ordinary, I have 30 in my class (mixed) with no support and sometimes I teach maths with 37 in my room, but I can honestly say that they have an excellent education and I can prove that each and everyone of them are moving forward with their education. The teaching and support staff throughout are totally committed to the needs of the pupils and the development of the school. They have access to wide range of iniatives which both motivate and stimulate them. I know that resources are stretched and that's why I feel state school teachers are so skillful in extracting so much.

Private schools are struggling in some areas to get bums on seats and so are accepting children with special needs or slightly less academic pupils. The very nature of the teaching styles in these schools will have to change. I guess that is the nature of running a business.

As for aiding state schools, I guess this migration frees up resources in some way, but there isn't really a benefit. As for privatisation, I don't think it will work. We already have partnerships with industry injecting cash and tbh I feel that is enough. My, that was more than I expected to say...!

[BDunnell]

We already have partnerships with industry injecting cash and tbh I feel that is enough.

And I'm sure that, as a teacher, you don't want to go too far down the road upon which schools in the US have embarked, involving sponsorship and thus incidents like the pupil who wore a Pepsi t-shirt during a 'Coke in Education' day at his school, leading to his suspension.

[Malbec]

We want the best service possible, free at the point of delivery, so who cares about who provides the care? It is regressive to think in the terms that getting private companies into the NHS is bad and they are going to screw it over - that is not always the case, most businesses try to simply break even, and are not as profit orienatated as people seem to think. We need cheaper, better drugs, if the private sector make them then why not buy them? If the NHS cleaners do a bad job then why not hire a private company who provide you with a service who you can get rid of them if they don't do a good job.

Just a few small notes. The private sector DO develop and manufacture ALL the drugs in the UK. The pharmaceutical industry in the West has always been privately run. Proof that the state sector doesn't do as well in this field is provided by the former USSR, whose drug companies failed to develop a single significant drug in the country's lifespan.

The current Labour government has already privatised a considerable section of the NHS. The NHS no longer employs a single cleaner, cleaning services were contracted out to private firms more than 5 years ago. The first thing those companies did was to cut pay which resulted in people leaving, so that they have struggled to recruit enough people since. These companies have to make a profit somehow. It doesn't take a genius to realise that with fewer cleaners doing the same job the quality of service drops.

While I agree there is a role for the private sector in British healthcare, I would prefer it to be along the lines of what BUPA has provided for many years, a parallel system that takes some of the pressures off the NHS.

What we have had instead for the past decade is abysmal. New hospitals are being built with private funding but at what cost? This government has bought £8 billion worth of fixed assets from Private Finance Initiative companies but has signed us up to paying an estimated £50 billion over the next 30 years paying it back. Bargain? Those PFI built hospitals are designed with very little input from the staff and are built with price in mind, hence cubicles are too small, not enough space is built in for storage etc etc. Also the building is still owned by the PFI. What happens if you need to extend a particular department? The PFI is in a position to demand over the odd expenses in order to accomodate your requests.

Then there's the NHS spine, the national computerised patient records system. Its cost £20 billion so far and isn't fully operational yet. Some estimates put the final cost at £50 billion. Its the largest non-military IT project in history, and according to Fujitsu who are one of the major contractors, it is never going to work in its current form. Thats good because if it DID work it would be illegal and unethical. Why? Because the government has decided that no British citizen will have the right to opt out of the system and this breaches fundamental human rights. This is an issue that will, if it continues along its current path, go up to the European court of human rights as both patients and GPs fight this government. One woman who has already tried to opt out was told that that would exclude her from ALL NHS healthcover.

The government has also been buying services from private suppliers to cut waiting lists but at a horrendous price in the form of Independent Sector Treatment Centres or ISTCs. In order to entice companies like Capio and United Health, they have effectively de-risked their entry into the market. They did this by guaranteeing payment and demand, ie forcing NHS hospitals to hand over their patients to these private suppliers AND paying them regardless of how many patients they actually operated on. The price the DoH paid per patient was also initially far more than it cost the NHS to operate on the same patients already.

Let me give you an example.

A private company was approached to build an elective hip replacement centre in the South of England. They built it after they were given the above guarantees. The NHS hospitals in the area were then informed that any hip replacements that were young fit and healthy would go to that new private centre, and the hospitals would pay the centre themselves. Portsmouth hospital took one look at the numbers and refused, they would have to pay several hundred more per patient to the ISTC than it would cost to do it themselves. They were then informed that they did not have the freedom to refuse.

In my understanding of the free market, there is no such thing as fixed/guaranteed demand. If you feel that you can do the same job cheaper yourself, there is little financial incentive to buy the same service from someone else. Hence ironically the private sector is entering the industry with strong national subsidies into the very opposite of a free market.

The hospitals in question still have to do the complex hip operations themselves, the private sector only cherry picks the easy (read cheap) ones. So they lose doubly. They make a loss on the hips they send to this private centre, see their average hip replacement costs go up as they only do the complicated ones and they have to cut bed capacity, there's no point keeping it if your easy hip replacements are going elsewhere.

Then there's the case of overseas radiologists being brought into the UK to work for private companies without adequate training, I can name a few hospitals on the South/South Eastern coast who have come to grief that way.

What we have now in the UK is a system where the nice potentially profitable bits have already been privatised to a degree. The next segment thats going to see privatisation over the next decade is the GP system. Expect to see your local practice being taken over by Boots, Lloyds, Tesco and Virgin over the next few years, the last GP contract included a bit of small print allowing non-GPs to take over practices and there have been a few low key take overs mostly in inner city areas already.

There are certain bits the private sector won't touch with a bargepole, elderly care, paediatrics, psychiatry and most importantly perhaps A/E as they involve too high a risk and investment for little potential return.

In many ways its too late to have a debate about this, the contracts with the private sector contain so many fines and penalties if the government backtracks that we are really committed to them for life. This debate about privatising the NHS should have been held in the House of Commons over 5 years ago, but there never was one. There certainly never was a public debate about it.

Isn't democracy great?

[BDunnell]

In many ways its too late to have a debate about this, the contracts with the private sector contain so many fines and penalties if the government backtracks that we are really committed to them for life. This debate about privatising the NHS should have been held in the House of Commons over 5 years ago, but there never was one. There certainly never was a public debate about it.

Isn't democracy great?

This comes back to what I was saying earlier about all the main parties in the UK trumpeting 'choice' as being a great thing in all sorts of ways, but not giving the electorate a choice when it comes to private sector involvement in the public services. All three major parties see this as being a good thing because they all feel the need to be 'business-friendly' and in support of private enterprise. It still amazes me that they are seemingly unable to see that the private sector isn't a panacea, as proved by the outstanding performance of public services (compared to our own) in many other European countries which decided not to neglect them over a long period of time and instead to give them adequate funding.

[Daniel]

Forgive me, but are you referring to public schools and private schools as the two different forms of private education, or to public schools in the US sense of state schools?

Bebee would be referring to the Australian system. Public schools in Australia = Government schools :)

[LotusElise]

Everywhere else has a better idea of what a public school is. British "public" schools are not for the public at all!

To add to the privatisation debate, I saw on TV not long ago that the part of the health service which supplies bottled oxygen to home-based patients who need it has been farmed out to a series of companies. Two of these companies had not been delivering oxygen as they should have done and then blamed "unprecedented demand". The list of patients had been handed over to them and they still hadn't ordered enough in. Computer errors were blamed, I think, but it smacks of profiteering or incompetence to me.

[Daniel]

And I'm sure that, as a teacher, you don't want to go too far down the road upon which schools in the US have embarked, involving sponsorship and thus incidents like the pupil who wore a Pepsi t-shirt during a 'Coke in Education' day at his school, leading to his suspension.
Schools here in Wales are already sponsored as such to put up advertising posters which advertise childrens movies :mark:

As for what Carl has said. I do sincerely hope that NONE of my tax goes towards paying for anything that his family uses and that I don't use. Of course I'm being sarcastic here....... but the point is that Carl, BDunnell, Caroline and myself all live in the UK under the same government and all of the tax we pay all goes to the same place and then gets dealt out. So if the government wants to do some work on a road near London because people are killed due to bad road design then that's fine and if the hospital here is too small then that tax money should go towards building a bigger hospital even if Carl or BDunnell will never use it or even see it. Now if Carl's son was to go to a government school I'd be more than happy if my tax went towards that or if Carl was sick I'd be more than happy if my tax went towards getting him better. Why must certain people be so selfish to only want their money to go towards what they want? What then if we don't have any money? Does that mean we're not entitled to any services at all? I kind of understand what you're talking about Carl, but it misses the point. We're not living in Tudor times where if you don't have a job or have no land you have no rights. We're living in the 21st century where people are supposed to be just a little less selfish and where you have basic rights and that comes at the personal expense of everyone who pays tax. It's not that hard.....

[LotusElise]

I try to think of it this way when I think too much about tax:
Even if I'm not using services, other people are. To put that into perspective, that means my parents, my brother, the other members of my family, my friends, the people I work with, the people who actually provide services that I do use and need, now and in the future, people who I know and might not class as a friend but certainly don't wish to see anything bad happen to...

We can't separate ourselves out from those around us.

[Malbec]

This comes back to what I was saying earlier about all the main parties in the UK trumpeting 'choice' as being a great thing in all sorts of ways, but not giving the electorate a choice when it comes to private sector involvement in the public services. All three major parties see this as being a good thing because they all feel the need to be 'business-friendly' and in support of private enterprise. It still amazes me that they are seemingly unable to see that the private sector isn't a panacea, as proved by the outstanding performance of public services (compared to our own) in many other European countries which decided not to neglect them over a long period of time and instead to give them adequate funding.

To be fair, when Labour came to power the public sector seemed like an inefficient monolith both at NHS and DoH level, which partly explains why they went for the more 'efficient' private route in 'improving' the NHS. Throw in a few guaranteed seats on the boards of a few of these private healthcare suppliers for MPs and the die was cast.

IMO a lot of the blame lies with the population at large and the press quite frankly, neither have bothered to be interested in what exactly the Labour party had in mind for healthcare in this country. Everything that Labour has planned has been in the public domain, but the press are not interested and the public simply never cared.

After all, a lot of the posts on this thread from British posters appear to be written on the premise that privatisation of the NHS is a future possibility, not the fait accompli that it is.

[Malbec]

I am happy that we have a choice in this country to do state or go private in both. I'm slightly less happy that I still have to pay for services that I do not use but I have no choice but to pay my taxes.

Your health insurance premium is much cheaper than it is, say, in the States because the private system here cherry picks what it will treat and what it won't. Everything that the private system doesn't look after is taken care of by the NHS anyway. Therefore you are still a potential user of the NHS, for example if you're badly injured in a car accident. You don't have a private option in such a scenario except perhaps for long term convalescence if your insurance stretches that far.

In countries where only the private sector exists or the national health system is too poor to use, private healthcare premiums and bills are much more expensive. Remember that in the US 50% of personal bankruptcies are due to excessive medical bills.

[Malbec]

What about Internal Markets which are entirely different. Internal markets are getting the positive aspects of markets into healthcare. It means that rather than the NHS doing everything like cleaning, logistics, food, building etc. Private companies are hired to do them, because they are cheaper and more efficient. Detractors say that you won't get the same quality of care, and because they are private, profit making companies they will cut corners to cut costs. In reality, the NHS will go for the one which offers best service, which is likely to be more expensive than the market rate, but still cheaper than the NHS doing it.

The Argument behind that is that there is no motivation for the NHS to be efficient- it has vast revenues set years in advance, it is impossible to sack people, so no one works thinking that if they arent good enough then they will lose thier job like you do in private industry.

You can always make the comparison between Soviet and western cars- because in the west, there is a market and competition for cars, the designers had to keep making better ones to maintain thier grip on the market. in the Soviet union they were driving the same cars in 1990 that they were in 1950 because there was no incentive to improve them- everyone worked for the Government and knew they wouldnt be sacked and lived in a comfort zone.

Firstly, this illusion about permanent employment in the NHS is nonsense. The unemployment rate for newly qualified nurses and physiotherapists is running at between 80-90% at the moment, and has been for a couple of years now.

Secondly the NHS has been roundly ripped off by a lot of suppliers. It simply isn't possible for the NHS to chop and change between cleaning contractors as easily as would be required to instil genuine competitiveness amongst them.

Also, the first step many contractors take is to cut pay amongst cleaners and porters, after all they need to turn an operation that was breaking even into one that turns a profit, and since increasing income is impossible on a fixed contract, that means reducing costs, the majority of which is spent on pay. Since these guys never got paid much in the first place, there is even less incentive for them to carry on with what is unpleasant backbreaking work. Not surprisingly there's a crippling shortage of porters and cleaners afflicting the NHS.

Hence hospitals get dirtier and ops get cancelled as there aren't enough people to move patients around from ward to theatre and back.

This government is cynical, it knows the cost of everything and the value of nothing. The NHS used to be run on goodwill, with people putting in far more hours than they were paid for. Now, with New Labour demanding that we account for every little action we do, and criticising us from a position of ignorance, that goodwill has simply evaporated from every tier of the NHS. That alone has made the whole system considerably less efficient.

People who don't work in the NHS but have experience in the private non-healthcare sector often look at various bits of the NHS and label it inefficient. What people don't appear to realise is that the NHS does not have financial efficiency as its primary objective, it never has. It has always been structured to deliver the safest possible healthcare to its patients while also maintaining an adequate throughput of patients. Where financial efficiency clashes with clinical safety, the latter wins every single time.

Hospitals are not factories that turn out identical products, they are there to treat human beings, many of which have radically different medical needs and require individually tailored care. That simply isn't a financially efficient business to be in I'm afraid.

[CarlMetro]

Schools here in Wales are already sponsored as such to put up advertising posters which advertise children's movies :mark:

As for what Carl has said. I do sincerely hope that NONE of my tax goes towards paying for anything that his family uses and that I don't use. Of course I'm being sarcastic here....... but the point is that Carl, BDunnell, Caroline and myself all live in the UK under the same government and all of the tax we pay all goes to the same place and then gets dealt out. So if the government wants to do some work on a road near London because people are killed due to bad road design then that's fine and if the hospital here is too small then that tax money should go towards building a bigger hospital even if Carl or BDunnell will never use it or even see it. Now if Carl's son was to go to a government school I'd be more than happy if my tax went towards that or if Carl was sick I'd be more than happy if my tax went towards getting him better. Why must certain people be so selfish to only want their money to go towards what they want? What then if we don't have any money? Does that mean we're not entitled to any services at all? I kind of understand what you're talking about Carl, but it misses the point. We're not living in Tudor times where if you don't have a job or have no land you have no rights. We're living in the 21st century where people are supposed to be just a little less selfish and where you have basic rights and that comes at the personal expense of everyone who pays tax. It's not that hard.....

I am not saying that I shouldn't pay taxes, I do so now, and a darn sight more than most on here for that matter too. What I am saying is that if I choose to pay for private health or private schooling for my son, that I should receive a small reduction in my tax bill. It worked for pensions, why can't it work for other things?

Not 100% on the year but it was early 1990's I believe when everybody in the country was give the option to opt out of SERPS, the state earnings related pension scheme. What this meant that the percentage of you National Insurance contributions that would normally go to the State pension could instead be directed into a private pension scheme instead. The advantages being that not only could you top up the pension with further payments if you wanted to, but also the fact that you should expect a greater return from a private pension scheme.

[LeonBrooke]

Something I've become aware of is that private hospitals don't accept the difficult cases. They accept nice, safe, straightforward cases which won't become complicated, but send the rest back to the public system........

[Geecee27]

My local NHS trust is responsible for three hospitals, 2 of which have recently been rebuilt in conjunction with private partnerships, the third is the biggest best equipped, busiest and covers the widest area. Guess which one has just been earmarked for closure? take your privatisation and shove it!!!!!!!

[jso1985]

It's hard to tell, basically I think that if the goverments would put more money on it rather than other stuff the services would be of course better and making it private won't really slolve the problem

But corruption seems to be the biggest problem with govermnet run things.
Here in Bolivia the gap between public and private health and education is huge, even some very poor funded private schools can manage to do much better than any public one, corruption cases are the daily thing there.
The only excetion in the gap is universities, with few expections, all public universities are better than most private ones, the funding they get isn't really big compared to the one the health or primary education system gets, the key for their success seems to be that universities have autonomy inside the goverment system and they manage by themselves their money and the authorities aren't designed from the Goverment Palace, so I think their autonomy makes it easier to handle it and makes corruption easier to spot and universities aren't affected by politics move the goverment can make
Don't know how it is in another countries but I think if a public system is managed directly by the goverment, political decisions get in the game too often and that clearly affects them

[Hawkmoon]

I think tinchote is right in that it is not a yes/no answer.

I tend to favour a mixed solution because there are problems with both public and private systems. Private organisations tend to be largely profit driven and this is not always compatible with healthcare and education systems. Public or government run organisations tend to be woefully inefficient because they are run by bureaucratic public servants.

I've seen public money wasted in our local hospital by being spent on the hospital administrator's office rather than maintaining the operating theatres ventilation system and I've seen the fees the top private school charges for kindergarten ($8000).

Just because the government doesn't own something doesn't mean that it can't regulate it's operation. A healthcare system can be privately run, thereby gaining the benefits of efficient management, but still be affordable to the average citizen through government money and regulation.

[raphael123]

I am not in total agreement about a private school education giving you a fuller life. Life experience is about more than just the time spent in school between 8am and 4pm. I had always believed that a private education was 'better' and in some respects it is but I think if I had a child I would send him/her to the local primary school. I just think that they would get a more well rounded view of the world. Having taught in both private and state schools I can see the advantages to both though. Perhaps it is the parents with a bit extra cash that can afford to take their children travelling etc that leads them to more life experiences.

The private school I taught in had small classes (all girls), enough classroom resources for all, plenty of space and excellent test results. However, the pupils didn't seem worldly, had enough of narrow view (probably instilled from their parents) to think that they were better than the other kids in schools in the area. As far as the teaching standards went I think it was fair to say that they were no better or worse than any state school I know. My present school is pretty ordinary, I have 30 in my class (mixed) with no support and sometimes I teach maths with 37 in my room, but I can honestly say that they have an excellent education and I can prove that each and everyone of them are moving forward with their education. The teaching and support staff throughout are totally committed to the needs of the pupils and the development of the school. They have access to wide range of iniatives which both motivate and stimulate them. I know that resources are stretched and that's why I feel state school teachers are so skillful in extracting so much.

Private schools are struggling in some areas to get bums on seats and so are accepting children with special needs or slightly less academic pupils. The very nature of the teaching styles in these schools will have to change. I guess that is the nature of running a business.

As for aiding state schools, I guess this migration frees up resources in some way, but there isn't really a benefit. As for privatisation, I don't think it will work. We already have partnerships with industry injecting cash and tbh I feel that is enough. My, that was more than I expected to say...!

Referring to life experiences, I wasn't just talking about just the school days. Maybe I've been given misguided information, but from what I know about my friends from Uni who went to a private school, they have all travelled the world to a greater extent than me, and anyone who I went to school with. However this was due to a mixture of both family holidays, and organised school holidays.

Needless to say again, but I'll say it again, children who go to a private school tend to end up having a better quality of life. This is fact, rather than an opinion. That's not to say everyone who goes to a state school ends up doing nothing, or that everyone who goes to a private school ends up being rich. But there is a relation between your earnings and whether you attended a state or private school.

However you haven't denied that have you? And what you say above I agree with generally. And you obviously have more first hand experience of this topic than I do, so I can accept you would know better than me :)

[Drew]

No no no.

You just create a bigger divide between the classes and then you end up with more crime and social problems..

[BDunnell]

To be fair, when Labour came to power the public sector seemed like an inefficient monolith both at NHS and DoH level, which partly explains why they went for the more 'efficient' private route in 'improving' the NHS. Throw in a few guaranteed seats on the boards of a few of these private healthcare suppliers for MPs and the die was cast.

The same can be said of the railways, which had a reputation far worse than the reality before they were privatised. I think a lot of the acceptance of these policies has to do with the common image of the private sector as brilliant, entrepreneurial and highly efficient, and the public sector as being a unionised monolith full of people who don't bother working to their best ability because they have jobs for life. Neither is true.


IMO a lot of the blame lies with the population at large and the press quite frankly, neither have bothered to be interested in what exactly the Labour party had in mind for healthcare in this country. Everything that Labour has planned has been in the public domain, but the press are not interested and the public simply never cared.

Absolutely. :up: Again, the same goes for other public services.

[Daniel]

Referring to life experiences, I wasn't just talking about just the school days. Maybe I've been given misguided information, but from what I know about my friends from Uni who went to a private school, they have all travelled the world to a greater extent than me, and anyone who I went to school with. However this was due to a mixture of both family holidays, and organised school holidays.

Needless to say again, but I'll say it again, children who go to a private school tend to end up having a better quality of life. This is fact, rather than an opinion. That's not to say everyone who goes to a state school ends up doing nothing, or that everyone who goes to a private school ends up being rich. But there is a relation between your earnings and whether you attended a state or private school.

However you haven't denied that have you? And what you say above I agree with generally. And you obviously have more first hand experience of this topic than I do, so I can accept you would know better than me :)
Perhaps the high quality of life that private school children lead is more down to the fact that they come from more priveliged backgrounds than actually the education they get......

[BDunnell]

Perhaps the high quality of life that private school children lead is more down to the fact that they come from more priveliged backgrounds than actually the education they get......

Yes, quality of life is a very different measure. I recall Stephen Fry saying that some of the thickest people he's ever meet went to public schools like the one he attended, which is a valid comment (and true).

[raphael123]

The inherant problem in the NHS is the culture- where the management does not follow common sense- in the example of claners etc they should sack the company they are with and get a new one- thats the point!

It simply isnt true that hospitals are crap- look at the performance statistics- things are way better- and of course the buildings are not built with profit in mind- they are used by a public body- there is no profit to consider.

PFI was always going to be expensive- but not at the cost you give- £50 billion is way over estimate, you are dealing with a nominal figure and it fails to take into account time purchase variations- it implies that the government will buy them all back in one lump sum in 30 years- not very likely. Plus what will inflation add to over 30 years? The reality is you are looking at a figure of less than 40% of figure quoted. this £50 billion is a statistical white elephant- so misleading it isnt funny.

The computerised system in almost entirely inplace and is working now- it is already saving lives. again, it was over budget- (name me one thing in this country that isnt?) but not by too much. Also the Job of the NHS is to cure people- and thy cannot do that if they don't have people's records and such. I mean why on earth would you opt out of a medical system- this woman must be mad- imagine if she has an accident, and there is some medicine she is allergic to? the dctors would not know!

No one is forced to go private- the whle policy os that people have the choice to get thier operations done now rather than later- and quite frankly, the state of our waiting lists 10 years age was frightening- something drastic needed to be done to cut them, or else they would never have been able to cut the backlog. That is a price worth paying.

All the examples you gave were reported in the Media- i can tell you they are all rubbish- I don't have time to go into all of them, but I will say that fro personal experiences, don't believe anything you read in the media.

In fact all these stories are the worst scaremenongering nonsense from the Liberal Democrat party- harly renowned for thier quest for truth and knowledge. The usual proceedure for these scare stories are that they come our of the liberal democrats and go into media, where they are investigate, and the truth is they are usually wild deviations from the truth, or a misrepresentation of the facts. remember the lady who was left on an operating table? the big hulabaloo that ensued was needless- it was discovered that the lady refused treatment by the black staff.

The fact is that we have brand new hospitals in britain, which work better than they did ten years ago, and are now going back to their performances in the 1970s. they have new technology availble to to them, and some of the worlds best medical support systems. Where internal markets fail is where they aare not operated properly- nyou are right- free markets mean supply and demand- if that is being tampered with then it isnt a true market.

My only real concern is that the managers are pretty useless- you're right- the NHS do get ripped off- though not as bad as is reported- and it's because the managers are not up to scratch.

a final word about employment- 80% of med graduates find a job immediately- a job most of them will not be able to be sacked from- though as you said this is changing.

Internal markets do work- they seem to work quite well accross the globe in fact. here the concern is that it is not being implimented properly, and management is not yet at the standard where they are capable of doing things on thier own. For years people have said take control of hospitals away from whitehall and give them to hospitals- which is what the government did, and then the problems you outlined occured. this is managerial, not philosophical.

[Malbec]

The inherant problem in the NHS is the culture- where the management does not follow common sense- in the example of claners etc they should sack the company they are with and get a new one- thats the point!

The point is that it is not so easy to cut and change suppliers, who often sign long term contracts. The core problem isn't so much the competition or lack of it, its the fact that there is this belief that the private sector can make a profit out of a field that the public sector was breaking even on, without dropping the quality of service given.


It simply isnt true that hospitals are crap- look at the performance statistics- things are way better- and of course the buildings are not built with profit in mind- they are used by a public body- there is no profit to consider.

Things are way better than what? Which performance statistics are you giving?

PFIs DO consider profit when they build their hospitals. That is why cubicles in A/E are no longer large enough to have a bed and oxygen/monitoring kit in place while also having enough room for staff to carry out resusc on a patient. That is why offices for clerical staff are built smaller than ever before, why they don't have room for expansion. They are built down to a price, not just with their use in mind.


PFI was always going to be expensive- but not at the cost you give- £50 billion is way over estimate, you are dealing with a nominal figure and it fails to take into account time purchase variations- it implies that the government will buy them all back in one lump sum in 30 years- not very likely. Plus what will inflation add to over 30 years? The reality is you are looking at a figure of less than 40% of figure quoted. this £50 billion is a statistical white elephant- so misleading it isnt funny.

What is your estimate of how much PFI is going to cost us then? I'm curious, because a friend of mine who works as a management consultant bidding for PFI projects seems to believe that its pretty accurate. I ought to let him know that his income projections are woefully overestimated if you are correct ;) .


The computerised system in almost entirely inplace and is working now- it is already saving lives. again, it was over budget- (name me one thing in this country that isnt?) but not by too much.

I think you've bought into the New Labour line as to why we 'need' this system hook line and sinker. It is hardly 'almost entirely inplace and is working now'.

The demographic segments of the NHS spine are online as you say. That is, you can trace a patients name/age/address etc. However the most important bit isn't, and that is the uploading of clinical details onto the system so it can be downloaded anywhere. It is that segment that is causing the most trouble, both from an IT security POV and from a human rights perspective.

With the current demographic details only system, there has already been one significant security breach, where a man waited for a secretary to leave her computer then used her login to trace his long estranged son from his name and DOB. The current system requires a password and a passcard to be in place. Pull out the passcard when you leave your desk and the system is supposed to lock up to prevent prying eyes, but it doesn't work, as evidenced by the example above.

With the clinical details, there will be several hundred thousand people who will be able to log into your notes with a few taps on the keyboard, as opposed to now whereby someone at your hospital has to go to considerable effort to get clinical records to pull your notes. Not only that, but there have been cases whereby clinical coding errors have been made. There are significant human rights issues with this.

Regarding the example of the woman I gave, try these links:
http://www.nhsconfidentiality.org/?cat=2
http://politics.guardian.co.uk/publicservices/story/0,,1937018,00.html

There are already several GP practices that are looking at refusing to upload any of their patient records onto the system unless specifically given permission to do so by their patients, as they believe their duty to protect their patient confidentiality overrides any duty they have to the government in power. When you have the most conservative profession on the planet willing to sign up to civil disobedience you have a problem on your hands.

This stuff about the need for every hospital to have your records online in case you have an accident far away from home is total nonsense. In the acute scenario it simply isn't as big an issue, certainly not £20 billion's worth especially with the vast majority of patients attending their local hospital in times of emergency. The real reason the Labour party wants this system is that it is the only way 'payment by results' where cash follows the patient round the system can be introduced. Everything else is fluff to keep the electorate quiet when they ask why the money needs to be spent.

And I haven't even bothered to go into 'choose and book', the other IT system that is causing nightmares.


No one is forced to go private- the whle policy os that people have the choice to get thier operations done now rather than later- and quite frankly, the state of our waiting lists 10 years age was frightening- something drastic needed to be done to cut them, or else they would never have been able to cut the backlog. That is a price worth paying.

This reliance on headline figures like waiting lists, A/E waiting times are a total con. They are fiddled with at every level. If you are happy being lied to then fine, if you are happy being ripped off while lied to then thats even better.

The problem is that this obsession with quantity is ignoring the quality of care given. Shortcuts have been made in the system to an incredible degree. Why employ doctors to diagnose and treat people in clinic when you can have several nurse specialists who have gone on an intensive six week training course instead? Never mind that they miss barndoor emergencies every once in a while. Who cares if a patient dies? Thats another one off the waiting list.


All the examples you gave were reported in the Media- i can tell you they are all rubbish- I don't have time to go into all of them, but I will say that fro personal experiences, don't believe anything you read in the media.

I don't particularly care for the media. They aren't reporting half of the disasters going on within the NHS. I rely on my own personal experiences. Again as I said above, if you are happy with the NHS as it is being portrayed to you by this government then I am glad.

I can however relate several stories of patients who have had their diagnosis delayed, important lifethreatening results missed due to dumbing down and streamlining, relying on minimally trained nurse specialists to do a doctors job. You won't find those in the press either.


The fact is that we have brand new hospitals in britain, which work better than they did ten years ago, and are now going back to their performances in the 1970s. they have new technology availble to to them, and some of the worlds best medical support systems. Where internal markets fail is where they aare not operated properly- nyou are right- free markets mean supply and demand- if that is being tampered with then it isnt a true market.

The problem is that we have paid over the odds for the new hospitals that have been built, and not enough thought has been put into why they are needed. New hospitals are built then promptly starved of funding.

Remember that stuff about Patricia Hewitt having a meeting about closing down hospitals in Conservative areas? Well the press forgot about it soon after but on the front line its pretty clear to me that that is coming into effect.

Several billion pounds were spent over the past decade bringing up south coast hospitals to scratch to cater for a new medical school in Brighton. Now, its becoming clear that Chichester, Worthing, Guildford and Epsom are going to close, and not a Labour constituency amongst them.


a final word about employment- 80% of med graduates find a job immediately- a job most of them will not be able to be sacked from- though as you said this is changing.

Do you mean doctors?

All UK graduates are guaranteed 1 years worth of employment post graduation, though they have substantially cut down the hours of each post while increasing the numbers, kind of jobsharing if you will.

At the top end, hospitals are cutting down on recruiting registrars and consultants. In certain fields such as mine (which is a supposed growth area), there are very very few jobs available and medical unemployment is a reality.

Medical unemployment rates tend to be artificially low. There are countries like Australia and NZ that have a shortfall of doctors, and I know many UK docs who have just left the country as they can't get a job and moved elsewhere.

As I said earlier, the UNemployment rate for newly qualified nurses and physios is still around the 80% mark.


Internal markets do work- they seem to work quite well accross the globe in fact. here the concern is that it is not being implimented properly, and management is not yet at the standard where they are capable of doing things on thier own.

I agree it has worked elsewhere, but it has not been implemented in a clear rational manner in this country. That is the problem.

[BDunnell]

remember the lady who was left on an operating table? the big hulabaloo that ensued was needless- it was discovered that the lady refused treatment by the black staff.

That story was brought into the open by the Conservative Party, I ought to point out.

I should add that I agree with everything that Dylan says, and believe his analysis is spot-on.

[raphael123]

I'd just like to point out I am against privatisation. I've said this from the start. I'm just trying to be open minded, and giving a counter arguement, even though if I had to choose I would choose against privatisation or internal marketisation.

BDunnell, I'm not going to get into discussions with you anymore on any topics (if I can help it anyway :) ), everytime I do, you fail to back up what you say by simply not replying. That's fair enough, it's your choice, but I do not see the point in having a discussion when you simply refuse to reply when someone asks you to back up what your saying :)

[BDunnell]

I'd just like to point out I am against privatisation. I've said this from the start. I'm just trying to be open minded, and giving a counter arguement, even though if I had to choose I would choose against privatisation or internal marketisation.

BDunnell, I'm not going to get into discussions with you anymore on any topics (if I can help it anyway :) ), everytime I do, you fail to back up what you say by simply not replying. That's fair enough, it's your choice, but I do not see the point in having a discussion when you simply refuse to reply when someone asks you to back up what your saying :)

What am I supposed not to have answered?

[Malbec]

I'd just like to point out I am against privatisation. I've said this from the start. I'm just trying to be open minded, and giving a counter arguement, even though if I had to choose I would choose against privatisation or internal marketisation

It doesn't really bother me whether people are for or against privatisation. What DOES bother me is that there simply hasn't been a debate about this, either at government level or at public level at all. The decision was taken unilaterally by New Labour to sell NHS services to the private sector at costs that give poor value to the tax payer.

Another thing that bothers me is the governments wholesale misinformation campaign about the NHS and its successes and failures as evidenced by some of your misconceptions.

If 2006 really was the best year for the NHS Patricia Hewitt wouldn't have been booed off the stage by the nurses, who had only a couple of years funded New Labour's election campaign AND funded an advertising campaign of their own encouraging people to vote Labour.

[BDunnell]

It doesn't really bother me whether people are for or against privatisation. What DOES bother me is that there simply hasn't been a debate about this, either at government level or at public level at all. The decision was taken unilaterally by New Labour to sell NHS services to the private sector at costs that give poor value to the tax payer.

Neither has there been much of a debate about the type of firms that are involved and the amount of leverage the government and local authorities ought to have over the private contractors. Very often, the latter don't think they have any, so choose to let the firms do as they please.

[Malbec]

Neither has there been much of a debate about the type of firms that are involved and the amount of leverage the government and local authorities ought to have over the private contractors. Very often, the latter don't think they have any, so choose to let the firms do as they please.

Quite often the local authorities really don't have any control, for example the DoH will negotiate with the independent sector directly for services in a particular area like London. Once they've decided who they will contract the services to, the local hospitals are then informed, not consulted, who will be doing the work.

What worries me is that traditional British based private health companies like BUPA are simply unable to win contracts because the big boys from the US, South Africa and European investment firm backed companies have come in to play the game. These guys are winning the initial contracts as loss leaders (even though their contracts are practically subsidised by the NHS). Later on, they will seek to recoup their investment and will increase their charges so they can make the profit they were always after, and thats when we'll really see costs skyrocketing.

[BDunnell]

Quite often the local authorities really don't have any control, for example the DoH will negotiate with the independent sector directly for services in a particular area like London. Once they've decided who they will contract the services to, the local hospitals are then informed, not consulted, who will be doing the work.

This is true. I should have said that I was referring to services other than the NHS.

A good example is local bus services. In my old job, we used to receive many complaints about these, and refer them to the County Council as the authority responsible for public transport service contracts. Their response was often that they have no control over those services that they don't subsidise. This was blatant nonsense, and it's surely repeated all over the country. Whether councils don't realise that they can wield some influence over private contractors, or whether they just don't bother and would rather keep out of it for some reason, I don't know, but it ought to be possible to exert pressure and have an effect when necessary.

I'm in complete agreement with you about the NHS, of course.


What worries me is that traditional British based private health companies like BUPA are simply unable to win contracts because the big boys from the US, South Africa and European investment firm backed companies have come in to play the game. These guys are winning the initial contracts as loss leaders (even though their contracts are practically subsidised by the NHS). Later on, they will seek to recoup their investment and will increase their charges so they can make the profit they were always after, and thats when we'll really see costs skyrocketing.

I am often irked by the fact that many people who complain about the poor quality of public services in the UK will presumably have supported governments who have supported the free market approach to such things without much thought to its effects when left unchecked. (The same goes for, as an example, people moaning about Indian call centres and such things.) Creating an entirely free market in public service provision seems all very well until its adverse effects are brought to bear. Again, the lack of debate on how far private sector involvement should go is largely to blame.

[raphael123]

I was just curious, by a debate, do you actually mean just a debate, or would you want it to go through consultation etc?

Some interesting points were bought up about using consultations in Question Time the other week.

[BDunnell]

I was just curious, by a debate, do you actually mean just a debate, or would you want it to go through consultation etc?

Some interesting points were bought up about using consultations in Question Time the other week.

This is a good point, because politicians go on about 'having a national debate' about something without saying what this means.

The problem with private sector involvement in the public services is that there is now no real debate on this in Parliament, because all three main parties are in favour of it. They just disagree on the details, rather than the overall concept.

[Malbec]

I was just curious, by a debate, do you actually mean just a debate, or would you want it to go through consultation etc?

Some interesting points were bought up about using consultations in Question Time the other week.

Ideally there'd be an open debate ending with a vote in the House of Commons where the facts could be aired and MPs could see what kind of deals we would be entering into.

But in the public arena, I'd like to see the press make a bigger effort in pushing to the public what the changes are, and what they mean so that the public can have an informed opinion and make a choice. This would also mean relying less on press releases from Millbank and doing more investigative journalism to give an independent view of what is happening, rather than simply relaying New Labour propaganda continuously.

The issues are certainly complex but any such debate would be better than what we have now which is total silence.

The press have previously made the EU/single currency, paedophilia and anti-terrorism regulation/human rights major issues, but on the NHS they are not interested.

[Malbec]

A good example is local bus services. In my old job, we used to receive many complaints about these, and refer them to the County Council as the authority responsible for public transport service contracts. Their response was often that they have no control over those services that they don't subsidise. This was blatant nonsense, and it's surely repeated all over the country. Whether councils don't realise that they can wield some influence over private contractors, or whether they just don't bother and would rather keep out of it for some reason, I don't know, but it ought to be possible to exert pressure and have an effect when necessary.

Perhaps there's an element of laziness? I have little experience of local councils but looking across the channel I think continental local councils are far more dynamic in the way they approach issues and sort them out, although working for the local council there has a kudos that is altogether lacking here so they probably have better staff quality.


I am often irked by the fact that many people who complain about the poor quality of public services in the UK will presumably have supported governments who have supported the free market approach to such things without much thought to its effects when left unchecked. (The same goes for, as an example, people moaning about Indian call centres and such things.) Creating an entirely free market in public service provision seems all very well until its adverse effects are brought to bear. Again, the lack of debate on how far private sector involvement should go is largely to blame.

The thing about interactions between the private and public sector is that because of the contrast in the ways they work, IMHO its all too easy for the private sector to get themselves a better deal than if they were working with other private sector companies. Plus IMHO there is greater scope for corruption that way too.

Most people's experience of private services come from private-private business interactions, ie their own experiences and therefore probably assume that public-private business interactions are equally efficient. I suspect the experiences of the past decade are starting to destroy that assumption. Or at least I hope so.

[raphael123]

Dylan H


The point is that it is not so easy to cut and change suppliers, who often sign long term contracts. The core problem isn't so much the competition or lack of it, its the fact that there is this belief that the private sector can make a profit out of a field that the public sector was breaking even on, without dropping the quality of service given.

Things are way better than what? Which performance statistics are you giving?

PFIs DO consider profit when they build their hospitals. That is why cubicles in A/E are no longer large enough to have a bed and oxygen/monitoring kit in place while also having enough room for staff to carry out resusc on a patient. That is why offices for clerical staff are built smaller than ever before, why they don't have room for expansion. They are built down to a price, not just with their use in mind.

What is your estimate of how much PFI is going to cost us then? I'm curious, because a friend of mine who works as a management consultant bidding for PFI projects seems to believe that its pretty accurate. I ought to let him know that his income projections are woefully overestimated if you are correct .

I think you've bought into the New Labour line as to why we 'need' this system hook line and sinker. It is hardly 'almost entirely inplace and is working now'.

The demographic segments of the NHS spine are online as you say. That is, you can trace a patients name/age/address etc. However the most important bit isn't, and that is the uploading of clinical details onto the system so it can be downloaded anywhere. It is that segment that is causing the most trouble, both from an IT security POV and from a human rights perspective.

With the current demographic details only system, there has already been one significant security breach, where a man waited for a secretary to leave her computer then used her login to trace his long estranged son from his name and DOB. The current system requires a password and a passcard to be in place. Pull out the passcard when you leave your desk and the system is supposed to lock up to prevent prying eyes, but it doesn't work, as evidenced by the example above.

With the clinical details, there will be several hundred thousand people who will be able to log into your notes with a few taps on the keyboard, as opposed to now whereby someone at your hospital has to go to considerable effort to get clinical records to pull your notes. Not only that, but there have been cases whereby clinical coding errors have been made. There are significant human rights issues with this.

Regarding the example of the woman I gave, try these links:
http://www.nhsconfidentiality.org/?cat=2
http://politics.guardian.co.uk/publi...937018,00.html

There are already several GP practices that are looking at refusing to upload any of their patient records onto the system unless specifically given permission to do so by their patients, as they believe their duty to protect their patient confidentiality overrides any duty they have to the government in power. When you have the most conservative profession on the planet willing to sign up to civil disobedience you have a problem on your hands.

This stuff about the need for every hospital to have your records online in case you have an accident far away from home is total nonsense. In the acute scenario it simply isn't as big an issue, certainly not £20 billion's worth especially with the vast majority of patients attending their local hospital in times of emergency. The real reason the Labour party wants this system is that it is the only way 'payment by results' where cash follows the patient round the system can be introduced. Everything else is fluff to keep the electorate quiet when they ask why the money needs to be spent.

And I haven't even bothered to go into 'choose and book', the other IT system that is causing nightmares.

This reliance on headline figures like waiting lists, A/E waiting times are a total con. They are fiddled with at every level. If you are happy being lied to then fine, if you are happy being ripped off while lied to then thats even better.

The problem is that this obsession with quantity is ignoring the quality of care given. Shortcuts have been made in the system to an incredible degree. Why employ doctors to diagnose and treat people in clinic when you can have several nurse specialists who have gone on an intensive six week training course instead? Never mind that they miss barndoor emergencies every once in a while. Who cares if a patient dies? Thats another one off the waiting list.

I don't particularly care for the media. They aren't reporting half of the disasters going on within the NHS. I rely on my own personal experiences. Again as I said above, if you are happy with the NHS as it is being portrayed to you by this government then I am glad.

I can however relate several stories of patients who have had their diagnosis delayed, important lifethreatening results missed due to dumbing down and streamlining, relying on minimally trained nurse specialists to do a doctors job. You won't find those in the press either.

The problem is that we have paid over the odds for the new hospitals that have been built, and not enough thought has been put into why they are needed. New hospitals are built then promptly starved of funding.

Remember that stuff about Patricia Hewitt having a meeting about closing down hospitals in Conservative areas? Well the press forgot about it soon after but on the front line its pretty clear to me that that is coming into effect.

Several billion pounds were spent over the past decade bringing up south coast hospitals to scratch to cater for a new medical school in Brighton. Now, its becoming clear that Chichester, Worthing, Guildford and Epsom are going to close, and not a Labour constituency amongst them.

Do you mean doctors?

All UK graduates are guaranteed 1 years worth of employment post graduation, though they have substantially cut down the hours of each post while increasing the numbers, kind of jobsharing if you will.

At the top end, hospitals are cutting down on recruiting registrars and consultants. In certain fields such as mine (which is a supposed growth area), there are very very few jobs available and medical unemployment is a reality.

Medical unemployment rates tend to be artificially low. There are countries like Australia and NZ that have a shortfall of doctors, and I know many UK docs who have just left the country as they can't get a job and moved elsewhere.

As I said earlier, the UNemployment rate for newly qualified nurses and physios is still around the 80% mark.



In response to some of your points.

1) In fact it is a myth that private companies make large profits- they simply dont- but they are better at working to a budget- look at all these public building rogrammes and compare them to private.

2) Of course they are better- rebuilt most of them, with modern equipment- Look at the fact that waiting times are down, provisions has increased, there has been the biggest hospital building programme since the 40s, cancer deaths are down, we deal with minor operations faster than 10 years ago, we now have have a hospital network which means that in the event of a nuclear, chemical, biological or explosive attack emergency services are now coordinated, the average waiting time is down etc.

3) The PFIs do not design hospitals- I checked this out at a local hospital event.they are built in limited sizes indeed to cut costs- i thought it was you who was worried about payback?!

4) My estimates come from NL records. I am referring to PVVM.

5) Again, from my experiences talking to doctors over the south east and london, it is only some parts which cannot get the full details. there are always problems with computerised records.

Looking at the rest of your comments, they seem to be personal remarks directed at me.

Yes I agree that there are problems- but that dosent mean the whole system is rotten or the whole Idea is crap- there needs to be better implimentation strategies.

You seem to care only the worse for the NHS, whereas I look for the best.

My final point on this matter is that you say that only schools in tory areas are under threat- WRONG. what about hastings, dover, motherwell, leicester, salford etc? the last three are in the constituencies of cabinate ministers.

Another point is that 10 years ago we diddnt have enough medical staff- now we have more than enough- which is the better place to be.

You really need to talk to a health minister, rather that a thinktank writer on the NHS for particularities!

PS: Must repeat, incase anyone takes it personally, I don't necessarily agree with this. Anyway, I think we've debated this quite extensively. I don't see any point in continuing it much further, unless something else comes up. But thank you, it's been interesting :)

[BDunnell]

Perhaps there's an element of laziness? I have little experience of local councils but looking across the channel I think continental local councils are far more dynamic in the way they approach issues and sort them out, although working for the local council there has a kudos that is altogether lacking here so they probably have better staff quality.

I think that's true, not least because of the power vested in local authorities in most European countries overseas by virtue of their more federalised political systems.

[Mark]

The only problem I have with PFI is that it seems to be very bad economics for the government. Sure they get a 'free' school or hospital now, but it costs them a fortune in payments down the line.

I should think they would be better off getting a bank loan!

[BDunnell]

The only problem I have with PFI is that it seems to be very bad economics for the government. Sure they get a 'free' school or hospital now, but it costs them a fortune in payments down the line.

I should think they would be better off getting a bank loan!

There are other problems that I think you ought to have, such as the ethical standards of some of the companies involved. This is important to me.

[Mark]

But wouldn't you agree that the government seems to be entering in a lot of long term deals, which will save them money in the short term but long term will leave future administrations with quite a hefty bill?

[BDunnell]

But wouldn't you agree that the government seems to be entering in a lot of long term deals, which will save them money in the short term but long term will leave future administrations with quite a hefty bill?

Absolutely. I was just adding another concern. The one you mention is probably the main one for me, too.

[Malbec]

1) In fact it is a myth that private companies make large profits- they simply dont- but they are better at working to a budget- look at all these public building rogrammes and compare them to private.

I'm not saying private companies DO make big profits.

My point is that there is an assumption that private companies can make a profit out of an operation that the public sector breaks even on without affecting the quality of service delivered.


2) Of course they are better- rebuilt most of them, with modern equipment- Look at the fact that waiting times are down, provisions has increased, there has been the biggest hospital building programme since the 40s, cancer deaths are down, we deal with minor operations faster than 10 years ago, we now have have a hospital network which means that in the event of a nuclear, chemical, biological or explosive attack emergency services are now coordinated, the average waiting time is down etc.

Again, this myth of the PFI hospital as one with superb equipment and organisation compared to a publicly funded hospital with outdated equipment, poor organisation etc.

You do realise that PFI only covers the building itself right?

The equipment within the hospital is bought or leased by the NHS seperately. There is no link between the quality of the building and the equipment within.

Cancer deaths are down? Actually cancer deaths are up as would be expected with a gradually aging population. Deaths due to SOME types of cancer are down, but there is little evidence either way to suggest that that is due to NHS reforms or epidemiological changes.

Again I refer you to my previous posts about the superficiality of the targets this government so adores.

BTW if you think that our hospitals are in a good condition to deal with an NBC attack you are very much mistaken. An attack a degree larger than 7/7 really will have the system creaking at the seams. As for bird flu, there is no government plan that we have been given for how to deal with it. Hospitals and PFIs have been left on their own.


3) The PFIs do not design hospitals- I checked this out at a local hospital event.they are built in limited sizes indeed to cut costs- i thought it was you who was worried about payback?!

I'm afraid they do.

One of my colleagues is on the board of a hospital commissioning a new build of considerable size which will be a PFI. He has considerable problems with the fact that the PFI supplier gets the final say as to the design, though the NHS trust has an input.


4) My estimates come from NL records. I am referring to PVVM.

What is PVVM?


5) Again, from my experiences talking to doctors over the south east and london, it is only some parts which cannot get the full details. there are always problems with computerised records.

Clinical records are not online ANYWHERE as part of the NHS spine. Demographic data is. All this is in the public domain, and the problems with getting the clinical data online are wellknown.

Perhaps you are getting confused with local PCT computer systems where local patient records are kept electronically but can't be accessed from elsewhere?

Try this article.

http://www.kablenet.com/kd.nsf/FrontpageRSS/9A5145232EC51506802572810048B813%21OpenDocument


Looking at the rest of your comments, they seem to be personal remarks directed at me.

They weren't directed at you, they were remarks about the nature of the lies this government is propogating.


My final point on this matter is that you say that only schools in tory areas are under threat- WRONG. what about hastings, dover, motherwell, leicester, salford etc? the last three are in the constituencies of cabinate ministers.

I was talking about hospitals, but I suspect that was a typo on your part.

Hastings is no longer under threat, since Worthing is almost certain to get the axe. Dover is not a full hospital, that area is covered by K/C, Margate and Ashford. Leicester is under threat, but the majority of hospitals threatened with closure are still in Tory areas.


Another point is that 10 years ago we diddnt have enough medical staff- now we have more than enough- which is the better place to be.

Brilliant! Another fantastic lie propogated by this government! You do realise that when they say 10000 extra doctors for the NHS they mean 10,000 new doctors have started to work but don't subtract the number that have retired, left or simply been unable to get jobs? There has been a small increase in doctors but they work fewer hours so the overall service delivered has remained unchanged.

Been to the wards lately? Nurse numbers are down across the board, though they are helped out by HCAs. Recruitment where possible has been frozen to cut costs.

And never mind the quantity, what about the QUALITY? Consultants now qualify with 10000 hours of experience as opposed to 40000 hours a decade ago. Tell me how that improves quality of care? Nursing training has gone to pot too.


You really need to talk to a health minister, rather that a thinktank writer on the NHS for particularities!

That would be the health minister who said that 2006 was the best year ever for the NHS? The one who claims that hospital closures are a sign of success? The one who claims that closing local A/Es will lead to an improvement in quality of care?

To be honest this is where the misunderstanding between us lies.

You actually believe this government. I don't. I work in the NHS in case you hadn't guessed, and I see the problems first hand. I also see the stupidity of the lies given by this current health minister who doesn't understand the basics of healthcare one bit.

I've seen patients die who wouldn't have died without the 'reforms' and 'reorganisations' foisted on the NHS by this government. Does that piss me off? You bet it does. But what annoys me even more is that there are people who fall for the government line hook line and sinker.


PS: Must repeat, incase anyone takes it personally, I don't necessarily agree with this. Anyway, I think we've debated this quite extensively. I don't see any point in continuing it much further, unless something else comes up. But thank you, it's been interesting :)

You raised interesting points so I'll respond.

Its a bit unfair that you accuse others on this thread of not responding to your questions yet deny others the chance to answer yours isn't it?

[Malbec]

There are other problems that I think you ought to have, such as the ethical standards of some of the companies involved. This is important to me.

I agree.

Its not just the NHS of course, New Labour is PFI'ing the military too.

I'm not too fussed when they PFI the rebuilding and refurbishing of the MoD buildings in Whitehall, but they're PFI'ing a lot of frontline services too, especially in supply and maintenance.

They're looking at PFI'ing search and rescue services soon as well. Call me old fashioned but when I get lost up in the Highlands with only a t-shirt and shorts on in arctic conditions I want a fully trained RAF/RN pilot and crew looking for me in the best equipment available, not the cheapest crew and helicopter that could be mustered together for a profit.

I wonder how long it will be before certain regiments are PFI'd?

[BDunnell]

I agree.

Its not just the NHS of course, New Labour is PFI'ing the military too.

I'm not too fussed when they PFI the rebuilding and refurbishing of the MoD buildings in Whitehall, but they're PFI'ing a lot of frontline services too, especially in supply and maintenance.

They're looking at PFI'ing search and rescue services soon as well. Call me old fashioned but when I get lost up in the Highlands with only a t-shirt and shorts on in arctic conditions I want a fully trained RAF/RN pilot and crew looking for me in the best equipment available, not the cheapest crew and helicopter that could be mustered together for a profit.

I wonder how long it will be before certain regiments are PFI'd?

To be fair, some of the ways in which PFI has been used in the military have worked quite well in practice (or, at least, not badly), such as the use of private contractors in flying training. Whether this actually ends up being good value for money is another thing entirely. It's also led to many talented people leaving the forces in favour of working for private defence contractors, because the opportunities are greater, more secure and better paid thanks to the deals the government puts their way.

Personally, I don't think any government would dare privatising any front-line regiments or squadrons. The public backlash would be too great. Maybe if they tried some more attention would be focused on the real costs of PFI deals in general, but I'm not holding my breath.

[Malbec]

Personally, I don't think any government would dare privatising any front-line regiments or squadrons. The public backlash would be too great. Maybe if they tried some more attention would be focused on the real costs of PFI deals in general, but I'm not holding my breath.

I'm sure there are PFI projects that do work, there are certainly some in the NHS too, but there are just too many ripoffs going on.

One of my friends works for the other side, bidding for PFI projects and at times he has serious guilt pangs regarding how much he's charging for the services he's delivering (and believe me, when it comes to money he really doesn't have much of a conscience). Since he mixes working with private clients with bidding for PFIs, he knows full well how much more efficient private-private business interactions are.

I gather its even more of a joke with IT, since the civil servants involved have even less idea of what is going on.

Perhaps PFIs have gone unchallenged because people find it too difficult to get a realworld grasp of the costs involved? If a CEO earns £1 million you can have an idea of how much that is but when a single IT project costs £20 billion and looks like ending at £50 billion... how do you get your head around those numbers?

[raphael123]

Dylan H, I have responded numerous times, I don't think it's fair to say I am denying other's the right to reply to mine. Your more than welcome to reply, as you have :) .

As it turns out I pretty much agree with what you say. I found the topic interesting (hence why I started it), and as no one seemed able to make a case for the opposite side, I thought I would try :) And as you say, you work in the NHS, so you have a great knowledge on the subject than me or anyone else here probably, and I take your word for what you say, and take it as correct :)

[BDunnell]

I gather its even more of a joke with IT, since the civil servants involved have even less idea of what is going on.

Indeed. Apparently, working on a contract for a Government agency or department is seen as a very cushy little number by many in the IT industry, in part because there is little monitoring (not least of costs). It doesn't matter whether the systems that get put in place by the contractor are totally unsuited to the demands of the particular organisation, because the people working on the project have no knowledge of the specific needs; the main thing is that it's being done by a private firm rather than the public sector. People have died because of the underlying ideological obsession.

[Malbec]

As it turns out I pretty much agree with what you say. I found the topic interesting (hence why I started it), and as no one seemed able to make a case for the opposite side, I thought I would try :)


So you were playing devil's advocate? gotcha...

[Malbec]

People have died because of the underlying ideological obsession.

Did you watch the programme on Tony Blair last night? It gave an interesting insight into how the government works, with top down implementation of reforms, with one ex-cabinet minister saying that new ones were ordered before the previous one had even been implemented. There didn't appear to be much consultation even between Brown and Blair, let alone with the cabinet, and forget the House of Commons.

An infatuation with the private sector is entirely in keeping with Blair's obsession with wealth and fame. I suspect that is where the real issue lies.

[Mark in Oshawa]

Well, as someone who is in Canada where we have no private alternatives to our health care unless we take our money and go to the US, I am all for it.

I wont wade through the previous 4 pages of this thread, I have heard the same arguments here over and over again. The fact remains, that the government is not to be trusted with my best interest in health care. They have had that monopoly for over 40 years now in Canada, and yet the waiting times for people with serious issues such as Cancers and other killer diseases is a joke when you consider that most of the problems are in the administration of the hospitals and attracting the personnel required to man the technology to find the cancers and diseases. This is a manpower issue, not a issue of money. Private concerns with governmental oversight and rules will always find a way to do the job better because they have it in their interests to do so. Governments cant seem to master this even though they have the same reasons to do so. It is a cultural thing that wont change. Government should do as little as possible except fund programs that will help the welfare of the nation, and put regulatory restraints on private concerns to guarntee some level of competance and performance.

The Government of UK or Canada or anywhere else has proven over and over again they cannot compete with the private sector for effienciency in health care and a lot of other areas, but they have to at least guarntee a level of service to the people they serve. So get on with letting the private sector work for you, not against you and get the hell out of the way! Meanwhile, people are still dying because proud politicians don't want to give up on the fiction they know best....

[raphael123]

So you were playing devil's advocate? gotcha...

Got it in 1. From the start I said I didn't agree with privatisation, but wanted to try and make a case for privatisation as no one else had, maybe you missed it :)

[BDunnell]

Well, as someone who is in Canada where we have no private alternatives to our health care unless we take our money and go to the US, I am all for it.

I wont wade through the previous 4 pages of this thread, I have heard the same arguments here over and over again. The fact remains, that the government is not to be trusted with my best interest in health care. They have had that monopoly for over 40 years now in Canada, and yet the waiting times for people with serious issues such as Cancers and other killer diseases is a joke when you consider that most of the problems are in the administration of the hospitals and attracting the personnel required to man the technology to find the cancers and diseases. This is a manpower issue, not a issue of money. Private concerns with governmental oversight and rules will always find a way to do the job better because they have it in their interests to do so. Governments cant seem to master this even though they have the same reasons to do so. It is a cultural thing that wont change. Government should do as little as possible except fund programs that will help the welfare of the nation, and put regulatory restraints on private concerns to guarntee some level of competance and performance.

The Government of UK or Canada or anywhere else has proven over and over again they cannot compete with the private sector for effienciency in health care and a lot of other areas, but they have to at least guarntee a level of service to the people they serve. So get on with letting the private sector work for you, not against you and get the hell out of the way! Meanwhile, people are still dying because proud politicians don't want to give up on the fiction they know best....

How, then, do you explain the many genuine problems that private sector involvement in the health service has caused in the UK? It has been far from efficient and far from cost-effective, when you look behind the rhetoric. Plenty of examples of this have been given in this thread.