Thought Id start this one going because its rather dead on this board at the moment and I suppose all my usual muckers are either at the Stella tennis event watching Dim Tim (lose again) or at Henly Regatta eating cucumber sandwiches (they wish,...NOT).

Anyway please feel free to just talk to yourself blast away and let it go on any company or subject you wish. Just wish Id thought of this one before.

cheers GF.

5.5% is an opinion poll, not a vote.

Been saying that for years clocktower, Freda is the biggest hypocrite on the planet. Plastic Marxist.

Fred's friends..


https://www.theguardian.com/politics/2018/jan/16/momentum-official-veteran-chair-labour-disciplinary-panel-christine-shawcroft-ann-black

A decent article from Moonboot, nail on the head!



The PFI bosses fleeced us all. Now watch them walk away


When contracts fail, the legal priority is still to pay firms like Carillion. Money is officially more valuable than life


George Monbiot
Tue 16 Jan 2018 18.45 GMT


Again the “inefficient” state mops up the disasters caused by “efficient” private companies. Just as the army had to step in when G4S failed to provide security for the London 2012 Olympics, and the Treasury had to rescue the banks, the collapse of Carillion means that the fire service must stand by to deliver school meals.

Two hospitals, both urgently needed, that Carillion was supposed to be constructing, the Midland Metropolitan and the Royal Liverpool, are left in half-built limbo, awaiting state intervention. Another 450 contracts between Carillion and the state must be untangled, resolved and perhaps rescued by the government.


When you examine the claims made for the efficiency of the private sector, you soon discover that they boil down to the transfer of risk. Value for money hangs on the idea that companies shoulder risks the state would otherwise carry. But in cases like this, even when the company takes the first hit, the risk ultimately returns to the government. In these situations, the very notion of risk transfer is questionable.

Nowhere is it more dubious than when applied to the private finance initiative projects in which Carillion specialised. The PFI was invented by John Major’s Conservative government, but greatly expanded by Tony Blair and Gordon Brown. Private companies finance and deliver public services that governments would otherwise have provided.

The government claimed that the private sector, being more efficient, would provide services more cheaply than the private sector. PFI projects, Blair and Brown promised, would go ahead only if they proved to be cheaper than the “public sector comparator”.


More: https://www.theguardian.com/commentisfree/2018/jan/16/pfi-bosses-carillion-money-george-monbiot

Lord Tennyson:

“Forward, the Light Brigade!”
Was there a man dismayed?
Not though the soldier knew
Someone had blundered.
Theirs not to make reply,
Theirs not to reason why,
Theirs but to do and die.
Into the valley of Death
Rode the six hundred."

Six Hundred Grand a year ++++ and that is where he sent his soldiers. Jail him!!

No mention of the Welsh NHS problems that's all over the BBC news this morning Fred ?

Oh yeah I forgot , run by Labour so let's keep quiet about that one.

Dil.

What is your explanation for the failings of the NHS in Wales?

But please don't blame Lloyd George.

For Dil.

A simple evaluation of the problems with the Welsh NHS.

Not considered are the customers.

=-=-=-=-==
http://www.wales.nhs.uk/sitesplus/documents/863/13.08.12%20FAQs%20around%20NHS.pdf

What’s the matter with the NHS in Wales? –
Some frequently asked questions
1) Are there really doctor shortages?
Yes. For a few years now there has been a problem with a shortage of
some types of doctors in the UK. The worst problems are in Paediatrics;
Emergency Medicine (A&E); Surgery; Anaesthetics; Medicine; Obstetrics
and Gynaecology, and Psychiatry. Not having enough doctors, particularly
those in the middle-grade ranks (senior juniors, so to speak); is making it
very difficult maintain safe medical rotas. This is making some services
vulnerable because without enough doctors they become unsafe. No-one
wants to run services which we know are unsafe, and where patients
could come to harm as a result.
The doctor shortage issue sometimes reaches a crisis point and forces
urgent changes. Neath Port Talbot Hospital is a case in point. We couldn’t
recruit enough doctors to keep a safe acute medicine service, and had to
then urgently move the service to other hospitals.
It’s not the first time doctor shortages have caused us problems. The
Children’s Ward at Singleton Hospital had to merge with the one in
Morriston Hospital in 2009 because of a shortage of paediatricians.
In 2008 the Minor Injury Unit at Singleton Hospital kept closing at very
short notice because we just didn’t have enough A&E doctors. In the end
GPs stepped in, and we also had to reduce the hours it was open.
So doctor shortages have been with us for a while … but the problem is
getting worse. Even though we have a higher doctor head-count than in
the past, we still don’t have enough to run modern-day NHS services.
Why?
There was a time when doctors worked or were on call for ridiculously
long hours, sometimes several days at a time. The European Working
Time Directive, which limits the hours people can be in work, has stopped
that – and that’s good news. After all, would you really want to be treated
by someone who was almost asleep on their feet?
2
Doctors working fewer hours though, mean we now need more of them to
run services. So that’s the first pinch point.
NHS services are evolving, and increasingly doctors want to specialise.
That’s great for patients, because their chances increase of being treated
by an expert in their field.
But that also means that there are fewer generalists to share the more
routine workload. It also means that doctors who specialise must have a
minimum number of cases each year to ensure they can maintain - and
expand – their specialist skills. This means services cannot be spread too
thinly, or these expert teams will not remain sustainable.
Also, in large specialties like Trauma and Orthopaedics or General
Surgery, modern standards insist that a minimum of eight Consultants
are now needed for a viable rota.
Smaller hospitals are therefore less attractive to some doctors as a result,
which makes it more difficult to fill vacancies; and a vicious circle begins -
which can affect things like junior doctor training and threaten some
services.
So the greater medical expertise developing in the NHS causes a second
pinch point.
There are also other changes to doctors’ work patterns. For example,
changes in the way doctors become Consultants. They now have different
training pathways, which mean they are less likely to remain as long in
the middle grades as they did in the past. So we have fewer of these
doctors available with this level of experience.
In addition, changes to the Consultant Contract across Wales in 2010
reduced the number of sessions they worked each week, so we need
more Consultants to maintain services.
Also, doctors in training (especially woman) are opting to work fewer
hours to support a more acceptable work/life balance. (One in 13 doctors
in training is now working less than full time).
So these changing work patterns all contribute to a third pinch point.
Traditionally, the NHS has recruited many of its medical staff from
abroad. This still happens, but tightened UK immigration rules in recent
3
years has made it more difficult to both recruit from abroad, and for some
foreign doctors working in the UK to be allowed to stay here.
(Meanwhile some of our UK-trained doctors are also leaving to work in
countries like Canada, Australia and New Zealand.)
Therefore, fluctuating numbers of overseas doctors has created a fourth
pinch point.
There is also a belief by some that Wales is not the first choice for some
doctors. The reasons for this may include inaccurate perceptions of the
country and its hospitals, or a mistaken belief that all medical staff must
speak Welsh. The Welsh Assembly Government is tackling this problem
with the Wales Medical Recruitment Campaign which includes recruitment
fairs across the UK; overseas recruitment drives; an active Research and
development programme; free accommodation for first-year trainees and
a Medical Careers Wales website.
ABMU also does all it can to promote a ‘whole package’ approach to
potential medical staff by providing practice and positive information
about the merits of working for ABMU and the local area.
So, the perception of Wales by some doctors as not their first choice of
where to work is the fifth pinch point.
All these factors have contributed to a longstanding and ongoing shortage
of doctors.
2) All these NHS changes – aren’t they really just about
saving money?
We don’t hide the fact that finance is a big problem. We are in the middle
of a major world-wide economic crisis and the NHS is not immune from its
effects. On top of that, our aging population is adding huge demands on
services, as are the growing number of people with long term conditions
like diabetes or chronic chest problems.
The Wales Audit Office estimates that by 2013/14 there will be a funding
gap of £250m to £445m in NHS Wales just to stand still on services. We
simply can’t afford to keep going as we are - we will just run out of
money and some services will collapse.
However, experience has taught us that if we have services which are
effective – (they help people get better faster) and efficient (they don’t
4
waste money, staff or supplies) – then they will also generally save
money.
A change in the way a service is run may not cost less up front – in some
cases it may even need additional investment. But, if change results in
any of the following, then the longer term pressures (including costs) are
likely to ease:
a) Patients don’t get ill in the first place, or as ill as they would have
before the change: Reduction in current and future demands on NHS
services
b) Patients receive the best care available, even if that means travelling
further: Better patient outcomes mean less need for follow-up care
and better future health. Better use of staff and resources
supports reliable, safe and affordable services
c) Patients spend no more time in hospital than they need to: Avoids
wasting resources; frees up beds for other patients, so reduces
costs of delays/rescheduling operations etc.
d) Patients avoid unnecessary complications or infections: Getting it
right first time avoids prolonging treatment and reduces the need
for follow up care
e) Patient outcomes are as good as possible – which means they recover
quickly or are as well as possible: Reduces the need for follow up
care, supports continuing good health
f) The risk of unnecessary harm or death is kept to an absolute minimum.
Reduces follow up care and reduces risk of compensation pay outs
(which can be millions of pounds, if, say, a birth goes wrong
because the NHS is at fault).
Could we consistently achieve all this by keeping services as they are?
The short, but emphatic, answer is no. We don’t always get there even
now.
We know, for example, that outcomes for patients using some hospital
services at weekends are not as good as they are on weekdays. And a
really stark figure is the RAMI (Risk Adjusted Mortality Indicator) rate for
ABM University Health Board – it’s higher than that of a typical English
peer NHS Trust. This means that some of our patients have a greater risk
of dying than similar patients in England. That’s just not acceptable.
5
We do provide a lot of health services well, and in some we offer excellent
results. But we can’t keep on providing all services in the same way that
we have. We will have to make big changes.
Ironically, people often equate the number of beds a hospital has with the
quality of the health service it provides. Yet there are more beds in
Wales: 3.9 per 1,000 population; than in England: 2.6 beds per 1,000
population. But English outcomes are generally better than ours.
So there’s much more to it than just pumping money into hospital beds.
Many of the potential changes we will be sharing over the autumn will
highlight other ways of delivering care.
Albert Einstein once said: “Insanity: doing the same thing over and
over again and expecting different results.”
Clearly, we have to keep that in mind as we all consider the need for
change!
So to sum up, money is a major factor in the changes ahead; but it’s not
the only one. Greater efficiency and effectiveness are just as important.
3) Why can’t all services be close to where I live?
Looking at the issues above you can see that staffing, finance, and
growing demands on NHS services are some of the main issues driving
change forward.
Even if we had limitless funds, we still wouldn’t have enough doctors
across ABMU to duplicate every service on every hospital site. And even if
we could find enough doctors, then the specialists among them would
become deskilled because they just wouldn’t see enough patients!
It’s not just doctors, either. There are also staffing issues with other
clinical staff, with many reaching retirement soon, for example. In short,
spreading all our services too thinly doesn’t really work. Patients would
not get the high level of expert care they expect and need in the 21st
century NHS.
We absolutely understand that travel issues are a big worry for many
people, and finding ways around this is very high on our agenda.
But the trade off for patients is this. Travelling a little further to a nearby
ABMU hospital instead of your local one for some services may be less
convenient. However, you are much more likely to be seen by an expert
6
team providing a sustainable service; and as a result, to get a better
outcome.
So should the question really be: Do you want the closest service, or do
you want the best service?
Of course hospital services are just one part of the NHS jigsaw. Just as
important are community-based services. Did you know that over the last
few years we’ve been investing in services like Community Integrated
Intermediate Care Service, or CIIS?
Evidence shows that most people do better when they are in familiar
environments, like their own homes. Many people, when given a choice,
prefer not to go into hospital. Services like CIIS are a halfway house
between GP and hospital care. Doctors, nurses and therapists deliver
tailored packages of care to patients directly in their own homes.
CIIS helps to prevent people from going into hospital, and also supports
people to leave hospital on time.
ABMU has also been investing heavily in several community-based
resource centres where some services which are traditionally found in
hospitals are now offered in community settings. These impressive new
buildings are like super health centres for the 21st Century, and offer
some diagnostic services and Warfarin services, for example, as well as
traditional GP and/or dental and pharmacy care.
So increasingly, more and more services will be available directly in your
local community which at one time would only have been in a hospital
setting.
The future is likely to hold more hospital ‘centres of excellence’ which
patients may need to travel to from time to time. But much of the routine
care which was once based only in hospital settings is moving into the
community – closer to people.
4) I’m hearing lots of rumours – when will decisions be
made?
This is a time of major change in the NHS, and the pace of it can be hard
to keep up with. But there are also processes in place to make sure
patients and the public are kept closely involved.
7
Sometimes, when patient safety is at risk, a change will happen urgently
– like the acute medicine service at Neath Port Talbot Hospital. But we
want to avoid urgent change like this as much as possible. We want
change to be planned, carefully thought through, and with the input of as
many interested parties as possible.
When major changes to NHS services are under consideration, Health
Boards in Wales must engage with Community Health Councils (CHC) and
the public an over their initial ideas. Then, depending on how the
engagement went, a formal consultation may follow.
If a CHC supports the change, the Health Board reports that to its own
Board and the change moves forward. If the CHC opposes the change, the
Health Board may amend the change until consensus is reached, or, if
that doesn’t happen, the issue may go to the Assembly for Ministerial
decision.
Currently there are two change programmes underway which affect
ABMU, and there is overlap in some of the services being reviewed in
each.
 Our own ABMU Changing for the Better, and
 The South Wales Programme, which involves ABMU, Cardiff and
Vale, Cwm Taf, and Powys health boards. (Hywel Dda has its own
change options but some of the services under review in the South
Wales Programme affect Hywel Dda residents too.)
Both programmes have involved hundreds of front-line doctors, nurses,
midwives and therapists who have been examining how services could
look in the future.
Changing for the Better has been looking at seven key service areas:
unscheduled care; long term conditions; care for frail, older people; care
of children and young people; maternity and newborns, staying healthy
and planned care.
In the South Wales Programme discussions have centred on major injury,
major sickness or problems during childbirth.
Public engagement on both starts in September, when more details will
be widely available.

-=-=-=-=-=-=--=-=-=-=-=-

There are Many Other Factors which are not considered in the above regarding "problems" in the Welsh NHS.

brevity is clearly not fred's forte ....... i hope you all enjoy reading; i didn't bother

I thought you had stopped posting on this thread cynic .

Cynic,

At your age, I would not expect you to.

Your ability to comprehend is getting more and more compromised.

But don't let your opinions get in the way of factual information.

Go for a nice walk Fred it'll do you good.

So it's first and foremost the EU working directive and secondly the short fall in funding by the Labour led Welsh Assembley.

Cheers Fred.

Dil,

You have the freedom to interpret the information as you wish.

The problems remain.

piss off fred ....... it has been truthfully said that if you cannot get everything you need to say on a single sheet of A4, then you are being too long-winded ...... assuredly this applies to you

Manuel,

You appear to have the time span of a 5-year-old child in difficulties.

That probably accounts for you forming ill-informed and poor opinions.

you only regard my opinion as poor and ill-informed because it rarely concurs with yours
your view of almost everyone on this board is little different

that does not make your opinion wrong but assuredly the same applies to that of others ..... or it may even be that many if not most times your pronouncements are truly a load of rubbish as seems to be the overwhelming opinion here

Dil, Does not just interpret your ramblings Fred1 but just states the facts as they are, because it appears you are blinded or so confused within your own ideology that you really cannot get a handle on the true situation that your Labour/Marxist friends are forming long lines and waiting around on hospital beds with the assistance of many hospital workers, with nothing more than a cold or some other minor excuse to avoid work and make the services of the NHS look as though they are underfunded by the Government to try to get your friends in power. Thank Heavens they will not get a look in.