"hope they work better than the "extra 6 inches guaranteed" generics Tyler buys from his Nigerian pharmacist" you should try a different conditioner like Pantene - I've had 6 inches of growth and never looked back.
A european socialized medical funding would work significantly better - the problem with rationing is that control can still be (and will be) maintained by the DoH; it is not above them to skew health spending into labour majority and marginal areas (cynical I know, but fully understandable human behaviour - dont bite the hand you rob; you'll attract their attention while doing so).
Not that I can talk- living in a labour marginal (they have the most councillors but are defeated often by a conglomerate of lib dems, tory's and, weirdly, the greens and the BNP!) I benefit from a decent hospital; it'd be a nice place if it wasn't for all the sick people...
But you are, like everyone else, looking at measurements of short term "outputs" and ignoring the long term benefits of all the extra GP prescribing (and our more cost effective use of generics is only worthy of a flippant comment too)and monitoring of long term conditions.
Audit has shown that GPs are making a difference, improving health and preventing heart attacks, strokes, renal dialysis requirements, blindness.
Just because an economist hasn't devised a way to measure an "output" doen't mean that there isn't an "output"
Most of the measures of "output" used in this study aren't very meaningful. It costs money to treat someone within 18 weeks, for example, but does nothing for the productivity stats.
Further of course, a recent VoxEU paper has proven (by accident, the libertarian authors thought they were producing data against central pay bargaining) that UK nursing pay still isn't high enough to prevent the private sector soaking skilled people away. We're reaping the whirlwind of 20 years of underinvestment, so most of the money has gone into fixing all the things that were about to break.
Sad really.
Meh,
Queuing theory is an interesting subject and one not understood by most politicians who somehow believe that decreasing queue lengths will require permanently higher resources (or conversely that they can save money in the long term by increasing queue (waiting) lengths . Unless people are dying whilst on the queue or choose to go private, the length of the queue makes little difference to the rate at which people are treated. This is why extra effort in reducing the queue at critical times (and so never letting it build up in the first place) means that queues can be largely avoided without considerably greater resources in the long term. It is counter-intuitive, but nevertheless true.
In short, to keep queue length (time) constant, you pretty much need the same level of resources whether the queuing time is one week or six months. Extra resources are only required to shorten queuing time - but once it is shortened you can go back to the old level of resources and keep the queue at the new (i.e. shorter) length.
On nurse shortages and pay the facts are that there really is no shortage of nurses in most areas, staff turnover is acceptable, and there are few open vacancies (other than short term) in most of the country. This is because, by most local standards, nurses' pay is relatively good. The problem only really exists in London and the South East, because there nurses pay is relatively less good - leading to more shortages and greater staff turnover. That's why pay bargaining should be decentralised. We overpay in much of the country and underpay in others.
hi Wat,
Agree with you about waste in the NHS, but disagree about the source. The fact is that you cannot change a lightbulb in a hospital, without advertising for a lightbulb fitter in the European journal. You then get charged something like £300 for it, when you could have jumped on a chair and changed it yourself.But you're not allowed to do that. you cannot even put a picture up on a wall (I kid you not) without getting the approved contracter in to do it.
As to bringing in more IT as the solution, I give you G Pass, NHS 24, MTA, and the National IT system. None of them work and all of them cost vast amounts of money. Kick out everyone with the word 'facilitator' in their job title and employ some more doctors and nurses and you might get there..
I would beg to differ when you say that nursing shortages are only a problem in the South of England. Other parts of the country have the same problem- many wards have an unacceptable qualified nurse to patient ratio, in my humble opinion (also the opinion of colleagues from nursing school that I have kept in touch with and are spread all over the country). Whilst I agree that the starting salaries for newly qualified staff nurses are pretty good, the potential earnings over, say 30 years are not so good. The numbers of Band 6 and above jobs are getting fewer and fewer. You may feel that being stuck at the top of Band 5 is going to keep staff happy- I can tell you from experience that it does not. If you want to keep experienced nurses on the wards where they belong then you need to give them a reason to stay....we are not talking megabucks here either...top of the Band 6 at the moment is around £30K (only £5K over the top of Band 5).
dino-nurse,
You may think there should be more nurses.
However, that is not the same thing as there being unfilled vacancies - in most parts of the country these are at very low levels as official statistics confirm.
The manager of a hospital in Newcastle was on the ratio the other day saying that they had low staff turnover and had no problem filling vacancies.
Starting salaries are very good, job security is high and pensions and retirement ages are good by any standards in much of the country.
Changes are afoot in the NHS pension scheme, just like everywhere else. Although at the moment it seems that it will stay as a final salary one, the retirement age will be increased. As for job security being very good...this depends on where you work/what grade you are. For example, recently in my neck of the woods, all the night sisters were told that because of the hospital at night" directives, they either had to accept new contracts (which downgraded them) or take a hike. We also have a situation at the moment where alot of senior staff nurses and sisters are having to compete for their own jobs or be downgraded. Finally, possibly the biggest scandel- senior sisters who are nearing retirement age being moved to manage wards/areas that they are unfamiliar with ( surgical sisters being asked to manage a cardiac ITU, for example)- presumably to force them to take early retirement. I cannot speak for hospitals in Newcastle. I can speak for my own Trust as well as several others (covering the Midlands, Somerset, Devon and Yorkshire). There are no vacancies because there are job freezes across the board in order to save money. This also accounts for low staff turnover- unless things get very bad most people would rather have a job than no job. Staffing levels are dangerously low on most acute wards where I work. Take a look on the NHS jobs websites.
dino-nurse,
You are missing the point. When I say that there is no shortage of nurses in most parts of the country, I am not commenting on whether hospitals etc. are understaffed. I am talking about whether it is hard to fill vacancies.
It is arguable that if hospitals are understaffed, it might be (at least partly) because they have run out of money due to the large wage increases for medical and nursing staff in recent years. If there are nurses wanting to work who can't find jobs, but there are insufficient staff in hospitals, it rather implies (as any economist would tell you) that wage levels should fall (or at least be determined according to local supply and demand). Of course, it doesn't work like this in the NHS - and this is to the detriment of the taxpayer, patients and unemployed nurses.
The present situation in nursing is similar to HM Forces - there may be no shortage of raw recruits, but highly experienced SNCO-level staff are leaving in droves.
Commenting by HaloScan
