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Stevo_666

meanredspider wrote:

Stevo 666 wrote:

meanredspider wrote:

I'd actually pay more tax voluntarily if I could choose where my tax went.

That's why I make charitable donations.

Me too - but it isn't the most efficient or coordinated way of funding healthcare. As an example (slightly indirect) I was astonished to hear of the "rift" (my word) between Guide Dogs for the Blind and RNIB over policy for the blind. Also, far too much of charitable donations ends up in the pockets of fund raising companies and administrators.

Maybe - but the main point is that I get to choose where (most of) it goes. That said, a lot of the tax we pay is taken up by government (effectively the fund raisers and administrators when it comes to tax) - a decent argument for a smaller state in itself.

Stevo_666

Tangled Metal wrote:

Beauty pageant taxation decisions. Can't see anything going wrong with that! :shock:

I don't personally use the trains so can I take the part of my taxes that.subsidizes that and put it into cancer research and care? I'm likely to get cancer so I think that's a better use of my tax pounds.

Then I don't use prisons, can I take money out off that for a tax reduction? Sorry, that's been done!

Well you get my drift. Even if you base fund everything and this is a top up, are you really the best person to allocate tax revenue? Also what part of representative democracy don't you understand?

If I choose to help by making charitable donations to the things that I feel are important then that's my choice.

Clearly I can't specify what are of government spending should be reduced but I can fund my charitable donations with a spot of personal tax planning if I so choose. You can argue till you're blue in the face about whether the government know better than me what to spend my hard earned money on but in the end I can increase how much goes to where I want to some degree

pblakeney

Surrey Commuter wrote:

But I am proposing a vote on whether to introduce a poll tax to raise money for the NHS. If nothing else it would be interesting to see if people were prepared to put their money where their mouths are when it comes to NHS funding. I suspect the majority think somebody else should pay for it and would vote NO.

rick_chasey

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Stevo_666

Rick Chasey wrote:

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Don't know enough to comment right now. Links?

rick_chasey

Stevo 666 wrote:

Rick Chasey wrote:

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Don't know enough to comment right now. Links?

NHS and Community Care Act
health authorities will manage their own budgets and buy healthcare from hospitals and other health organisations. In order to be deemed a "provider" of such healthcare, organisations will become NHS Trusts, that is, independent organisations with their own managements.

mrfpb

Stevo 666 wrote:

Rick Chasey wrote:

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Don't know enough to comment right now. Links?

https://www.youtube.com/watch?v=8CSp6HsQVtw


Try this - post-Lansley reforms. I posted it on an NHS thread a couple of years ago, but not much radical change since then. Worth noting that NHS Protect, responsible for combating inefficiency and fraud in the internal market (and NHS England generally), had it's budget slashed since this video was made.

fenix

Sooo they buy in healthcare from private companies who then have to make a profit off it ? Hmmm.

mrfpb

It's important to remember that many front line services - GPs, Dentists, Opticians have been private contractors for the NHS since it was created. GPs are essentially private partnerships that have local contracts. That's why having GPs as the main decision makers on Clinical Commissioning Groups (CCGs) has the potential for dodgy dealing - especially as many GPs will be investors or owners in private nursing homes or other secondary health organisations.

meanredspider

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

rick_chasey

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Proportional representation FTW.

meanredspider

Rick Chasey wrote:

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Proportional representation FTW.

That just reminded me of a joke my godfather used to tell:

A group of German soldiers have been stuck in a bunker on the Eastern Front for months when their officer arrives:
"I have zee good news and zee bad news"
"Zee good news is zat you vill all have a change of underwear"
Cheers go up amongst the men
"Zee bad new is zat Fritz vill change with Hans...."

Proportional representation just shuffles the problem.

rjsterry

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Because you're a bloody grown-up for crying out loud.

Sorry

We already have a problem with short-termism in politics - what you are suggesting would make this even worse.

bompington

Rick Chasey wrote:

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Proportional representation FTW.

Yeah, it's working out great so far in Scotland

mamba80

Stevo 666 wrote:

Tangled Metal wrote:

Beauty pageant taxation decisions. Can't see anything going wrong with that! :shock:

I don't personally use the trains so can I take the part of my taxes that.subsidizes that and put it into cancer research and care? I'm likely to get cancer so I think that's a better use of my tax pounds.

Then I don't use prisons, can I take money out off that for a tax reduction? Sorry, that's been done!

Well you get my drift. Even if you base fund everything and this is a top up, are you really the best person to allocate tax revenue? Also what part of representative democracy don't you understand?

If I choose to help by making charitable donations to the things that I feel are important then that's my choice.

Clearly I can't specify what are of government spending should be reduced but I can fund my charitable donations with a spot of personal tax planning if I so choose. You can argue till you're blue in the face about whether the government know better than me what to spend my hard earned money on but in the end I can increase how much goes to where I want to some degree

Its good you do this and i ll be sending you a JustDonate link in nr future! in fact you ll get a chance !

but for an awful lot of things, we need national coverage and not just regional provision, after all, why was the NHS universal education etc etc set up in the first place, if all was rosy and taken care off by the private sector and charities?

and that was when medicine was no where nr as expensive or complicated as it is now.

interesting concept ....though i wonder how much the trident replacement charity would get???

rick_chasey

bompington wrote:

Rick Chasey wrote:

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Proportional representation FTW.

Yeah, it's working out great so far in Scotland

Issue in Scotland is the Westminster bit :P.

bompington

Fenix wrote:

Sooo they buy in healthcare from private companies who then have to make a profit off it ? Hmmm.

When will people manage to get rid of zero-sum thinking?
The point is that when people have to compete, they find more efficient ways of doing things. When they don't everything inevitably becomes more sclerotic and bloated.
Just one example: I work in a state school. If I want to buy anything for my classroom - let's say a USB cable - I need to spend my time finding and filling in a purchase request form. Someone from the office then wastes their time and mine by arguing about it, and eventually we agree to buy it: it will come from the official supplier, who have a cosy monopoly, so it will cost about a tenner.
When I worked at a special school - so effectively private sector - I would have ordered it from ebay for 99p without leaving my desk or interrupting the class. Whenever I next passed the office I would have called in and been reimbursed the cash in seconds.

Or another one:
The NHS is quite remarkable and I have a lot of time for the many dedicated and excellent people in it (Mrs Bomp is a doctor), but you can't deny that there are inefficiencies.

I've just spent the best part of a day getting my pre-op assessment for a hip resurfacing.
Again.
Because it goes out of date after 6 months, innit?

So I take up staff time, consumables, resources. But if they could just do the op less than 4 months overdue then they wouldn't have to do any of this.

But nobody has any incentive to do anything about it.

TLDR: do you remember what phone services were like when it was a nationalised monopoly?

bompington

Rick Chasey wrote:

bompington wrote:

Rick Chasey wrote:

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Proportional representation FTW.

Yeah, it's working out great so far in Scotland

Issue in Scotland is the Westminster bit :P.

Oh, isn't it just?
It's the SNP's get-out-of-jail-free card:
"Nicola, why are the schools in Scotland so crap?" "it's those nasty London torees"
"Nicola, why is the NHS in Scotland so crap?" "it's those nasty London torees"
"Nicola, why is it raining again?" "it's those nasty London torees"
and so on ad absurdum

meanredspider

rjsterry wrote:

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Because you're a bloody grown-up for crying out loud.

Sorry

We already have a problem with short-termism in politics - what you are suggesting would make this even worse.

Absolutely we do - I don't see how this would make it worse. It's no wonder we're disengaged. We vote once every 5 years and we may or may not get someone who represents some of our views - meanwhile the world changes, they get it wrong and we vote in a different lot that change course completely. We get mediocrity at best.

briantrumpet

bompington wrote:

Fenix wrote:

Sooo they buy in healthcare from private companies who then have to make a profit off it ? Hmmm.

When will people manage to get rid of zero-sum thinking?
The point is that when people have to compete, they find more efficient ways of doing things. When they don't everything inevitably becomes more sclerotic and bloated.
Just one example: I work in a state school. If I want to buy anything for my classroom - let's say a USB cable - I need to spend my time finding and filling in a purchase request form. Someone from the office then wastes their time and mine by arguing about it, and eventually we agree to buy it: it will come from the official supplier, who have a cosy monopoly, so it will cost about a tenner.
When I worked at a special school - so effectively private sector - I would have ordered it from ebay for 99p without leaving my desk or interrupting the class. Whenever I next passed the office I would have called in and been reimbursed the cash in seconds.

Or another one:
The NHS is quite remarkable and I have a lot of time for the many dedicated and excellent people in it (Mrs Bomp is a doctor), but you can't deny that there are inefficiencies.

I've just spent the best part of a day getting my pre-op assessment for a hip resurfacing.
Again.
Because it goes out of date after 6 months, innit?

So I take up staff time, consumables, resources. But if they could just do the op less than 4 months overdue then they wouldn't have to do any of this.

But nobody has any incentive to do anything about it.

TLDR: do you remember what phone services were like when it was a nationalised monopoly?

Yes, re phones- it was a mess, and expensive. Waiting lists for a basic service. British Rail was also a mess. (SNCF might look all bright and gleamy from a distance, but it's in a financial mess now too.)

Re NHS - if the American model is the example of what happens when private enterprise drives the business model, I'd rather stick with the annoying inefficiencies of what we've got: better average outcomes for way less money, and no-one's stopping anyone going private, if they want to.

mamba80

well of course phones systems were expensive/cr@p, you needed an army of techs to keep the relays clean and cables were cardboard insulated and prone to water damage
exchanges were huge and the management p1ss poor so jumper changes took forever and were done at weekends & evenings to boost pay..... its also about economies of scale too, how many more people have phone lines compared to 30 years ago? the kit is small and ultra reliable.

Now its all remote programing and one openreach tech for several exchanges, but dont think for one moment the inefficiencies have gone, they ve just moved around lol! some of the stuff i see that goes on in the private sector/open reach is mind boggling inefficient

Jez mon

bompington wrote:

Fenix wrote:

Sooo they buy in healthcare from private companies who then have to make a profit off it ? Hmmm.

When will people manage to get rid of zero-sum thinking?
The point is that when people have to compete, they find more efficient ways of doing things. When they don't everything inevitably becomes more sclerotic and bloated.
Just one example: I work in a state school. If I want to buy anything for my classroom - let's say a USB cable - I need to spend my time finding and filling in a purchase request form. Someone from the office then wastes their time and mine by arguing about it, and eventually we agree to buy it: it will come from the official supplier, who have a cosy monopoly, so it will cost about a tenner.
When I worked at a special school - so effectively private sector - I would have ordered it from ebay for 99p without leaving my desk or interrupting the class. Whenever I next passed the office I would have called in and been reimbursed the cash in seconds.

Or another one:
The NHS is quite remarkable and I have a lot of time for the many dedicated and excellent people in it (Mrs Bomp is a doctor), but you can't deny that there are inefficiencies.

I've just spent the best part of a day getting my pre-op assessment for a hip resurfacing.
Again.
Because it goes out of date after 6 months, innit?

So I take up staff time, consumables, resources. But if they could just do the op less than 4 months overdue then they wouldn't have to do any of this.

But nobody has any incentive to do anything about it.

TLDR: do you remember what phone services were like when it was a nationalised monopoly?

Sounds exactly like working at a private company to be fair...

rjsterry

meanredspider wrote:

rjsterry wrote:

meanredspider wrote:

I'm just throwing ideas about because I don't think the current systems serves us well. We're seeing a fall-off in engagement (my view) and because I don't particularly buy into much of what any party is proposing. I like bits of each though. So why can't I vote for the bits I like? Idealist I know but surely we can do better than voting for somebody to represent us for everything from wars to trains to schools to tax once every five years.

Because you're a bloody grown-up for crying out loud.

Sorry

We already have a problem with short-termism in politics - what you are suggesting would make this even worse.

Absolutely we do - I don't see how this would make it worse. It's no wonder we're disengaged. We vote once every 5 years and we may or may not get someone who represents some of our views - meanwhile the world changes, they get it wrong and we vote in a different lot that change course completely. We get mediocrity at best.

Take Heathrow 3rd runway. That has been running for decades because every time a decision becomes due, there's an election coming up and everyone sits on their hands for fear of making an unpopular decision. I've seen it at the small end of the scale: try getting a slightly controversial planning application through when local elections are due.

Stevo_666

Rick Chasey wrote:

Stevo 666 wrote:

Rick Chasey wrote:

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Don't know enough to comment right now. Links?

NHS and Community Care Act
health authorities will manage their own budgets and buy healthcare from hospitals and other health organisations. In order to be deemed a "provider" of such healthcare, organisations will become NHS Trusts, that is, independent organisations with their own managements.

Tbh not that interesting to me. Sounds like the usual Labour effort to stop a government body behaving in some sort of commercial fashion and stopping competition though.

Why are you interested in my view on it?

mamba80

Stevo 666 wrote:

Rick Chasey wrote:

Stevo 666 wrote:

Rick Chasey wrote:

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Don't know enough to comment right now. Links?

NHS and Community Care Act
health authorities will manage their own budgets and buy healthcare from hospitals and other health organisations. In order to be deemed a "provider" of such healthcare, organisations will become NHS Trusts, that is, independent organisations with their own managements.

Tbh not that interesting to me. Sounds like the usual Labour effort to stop a government body behaving in some sort of commercial fashion and stopping competition though.

Why are you interested in my view on it?

i was interested in it, when my mum needed care at home in order to leave Hopsital, they (nhs) went to external care providers and put out a competitive tender process.... it took so long she died in hospital....incidently, they didnt even get a price, we recently got a letter from the nhs saying they d not yet got a care package...mum died last august.

you seem to think that health care is like getting someone to tarmac the local road.

rjsterry

Your experience would seem to confirm the general pattern of care providers shutting up shop or going under as there is so little money to be made. The problem of a sole customer with a fixed price they will pay.

rick_chasey

Stevo 666 wrote:

Rick Chasey wrote:

Stevo 666 wrote:

Rick Chasey wrote:

Stevo - what's your take on labour wanting to remove the NHS internal marketplace?

Don't know enough to comment right now. Links?

NHS and Community Care Act
health authorities will manage their own budgets and buy healthcare from hospitals and other health organisations. In order to be deemed a "provider" of such healthcare, organisations will become NHS Trusts, that is, independent organisations with their own managements.

Tbh not that interesting to me. Sounds like the usual Labour effort to stop a government body behaving in some sort of commercial fashion and stopping competition though.

Why are you interested in my view on it?

Tories are doing the same

bompington

Rick Chasey wrote:

Tories are doing the same

They seem to have forgotten that they are in favour of the free market

rick_chasey

bompington wrote:

Rick Chasey wrote:

Tories are doing the same

They seem to have forgotten that they are in favour of the free market

Also economically illiterate judging from this from the manifesto.

https://twitter.com/JoMicheII/status/872184880515493889



I mean, that'd get you an F in your A level Economics exam. Seriously.

Jez mon

Ignoring the economic slant, a government gets far greater impact on future generations than just spending more/less money.