Exactly, people on the phone in 2023.
Not quite your age but I do remember to tell Sid.
Have you seen Sid?
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My tuppence worth on health care is there needs to be more investment into the NHS, as well as wholesale reform of how it is run. It should be a crown jewel for what it means to be British, but it is tattered around the edges, and should instead be treasured and built up to world class status.
I grew up in the UK, we had our two kids there, and one of them had a seizure disorder and we received world class care for her. When we moved to the States they were impressed with everything that had happened for her, and said it was in keeping what they would have done here, as she transferred care from the NHS to our private insurance over here. People here are amazed to hear we never received a bill when our kids were born, and that you could go to the doctor, get a prescription, and no matter what it was for, pay just a few quid as a flat fee.
It is easy to talk about what’s wrong in health care in the UK, and also in the USA for that matter. And it is easy to score points back and forth on the issues.
Here’s what I will say though:
How much money do we think world class health care should cost?
From memory (I looked at it a while ago) people pay, per capita, $11k for health care in America. In the UK it was somewhere between $4-5k.
In America, the cost is too high, as too many expensive tests are run, as the legal profession has its claws in the health profession, and everyone is scared of getting sued, so they are paying lots of money for expensive insurance and also running too many expensive, diagnostic tests.
In the UK, people are not paying enough for world class health care. That’s my honest opinion having lived there for 37 years and had a family there too.
My sense is that there is a world class sweet spot somewhere between the UK and US costs. The NHS should not be politicized. It should be treasured. And the population needs to get real with regard to how much world class health care costs, too. And then of course, put the best joined up IT systems in place, and so on and so forth.
Morally speaking, I much prefer health care, available to all, at the point of need. I would much rather that was the system in America.
Bought and paid for by the working population, on the understanding that you can’t have something world class on the cheap.
Good answer. Do you think one business could run the NHS in its entirety or would there be numerous contracts and subcontracts etc.
I’ll tell you now, as soon as you get multiple businesses running under the umbrella of a public service it will falter, as it is already.
You either reign back from wherever are now, or you go full private contracts but keep the contract management costs separate. Good luck with that.
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Just beat you there.
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Hang on……
OK as I thought the NHS is the country’s biggest employer. I wonder how TESCO as an example would deal with it. Multiple sized sites doing “jobs” around the country. All run pretty much like clockwork. Yes there are a thousand differences / skill sets etc but the principle is the same. Logistics, staff, training, customer care, buildings, organisation etc.
Which was the British Gas campaign. What’s it got to do with BT?
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Nah was in response to yours …wasn’t one of the adverts of someone climbing up Everest to ask someone of they’d seen Sid ?
Also know what you mean about years ago with the phone engineer taking months to come around and install …great days especially that old number where you could dial up and listen to the top 40 songs
Damn was it ? …must have remembered when it was untied utilities 
Similar time.
All really good points, but the missing part of this, as is the case in any discussion about funding the NHS is not what it costs to have a good health service, but what it costs to not have a world class health service.
The topline figures on funding the NHS are misleading, because while the taxpayer is funnelling more money than ever into the NHS, a lot of that is being sucked straight into the private sector. The NHS has become in large part a commissioning service, taking public money to buy in private sector services and this doesn’t come cheap.
But a society where people don’t have access to healthcare, whether that’s because it’s shit or because it’s unaffordable will feel the impacts of that downstream, as the population becomes less healthy and resilient as a result of decreased access to healthcare.
In that IMF report that demolished Cameron and Osbourne’s rationale for austerity (I mention it a lot) healthcare was one of the sectors where investments generally return a positive investment back to society.
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Gas, Telecoms, Trains. What’s the difference?
They are miles different. Tesco stuff is easily packaged and scheduled, logistics as you say. That’s how they get produce on the shelves on time. Health care is not. It is not a sausage machine. Every case has similarities but is also unique. It gets extremely difficult to break things down into work packages or things that have rates. Unless you go cost+ and that’s a slippery slope that demands massive control and every facet questioned and checked.
Secondly, contracts need to be managed. Managed by whom? This is partly why the NHS is currently rammed with managers and not nurses.
Thirdly there is not one contractor out there that can deliver, operations, nursing, asset maintenance, parking, ambulance service, food and cleaning as a starter. So you’re straight into the realms of multiple contracts, all being managed by one contractor and being overseen by an NHS management team. Your health care costs have just gone through the roof.
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Didn’t gas and elec only work 3 days a week before the first Female prime-minister in history turn up? I might be wrong.
I was responding to @Flobs who asked how Old I was and I was quoting (what I thought) was the BT advertising slogan. I was wrong but it was the same period. Proving I do remember the days when BT were the square root of bloody useless. Thanks for pointlessly pulling me up.
Happy to return the favour.
Also in terms of a central database, a packet of Tesco’s sausages does not need its privacy guaranteeing which was one of the main sticking points of a national NHS database.
One of the biggest problems is that the more integrated the database, the more people have access to it, and the more potential there is for people to get hold of personal data they would rather be hidden.
As the NHS database died a death before data leaks and cyber attacks because common place, I reckon we dodged a bullet on that one.
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It was about 6 months for me to get a new phone connected in 2002 and for largely the same reason it took for ever in the 1970s: I needed a new cable to be run from the exchange - or, at least the switching cabinet which was around 4km away.
There are two reasons why new phone lines are much faster to install than it used to be: with packet switching there is much less new cable required for each new line and, overall, all the infrastructure is already in place.
The problem comes when new infrastructure is required. Specifically, high speed fibre. This was highlighted as a major problem in the mid-2000s and the UK is still struggling with it now. Supposedly the privately run telecoms companies are obligated to do this but if there is little profit in it they are loathe to install the new infrastructure.
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I think more of the problem is the government getting the idea to flog the data to data-mining companies. There is a legitimate use for statistical data. This has been used to improve screening and survival rates for things like breast and colorectal cancers. However what they want to do is to give the raw data to third parties. It’s not possible to completely anonymise that data but it’s very hard to convince people of that when there are dollar signs in front of their eyes.
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