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I have little doubt that NHS spending in England has been inefficient and inappropriate but I don’t think government policy is entirely to blame for that. A general trend to pay top executives big money “to attract the best” certainly doesn’t help with effective allocation of funds. Neither does creation of a computer system from scratch, rather than buying an existing system. I have seen the effects of both of those in industry and it isn’t pretty!

Treating the NHS as a political football has prevented necessary reform but neither the Conservatives policy of privatisation nor the Labour policy of protecting their great achievement (and the NHS was a great achievement) will get the job done. The front line staff are generally excellent but there aren’t enough of them and they aren’t supported properly. If, as is suggested, the money is there where is it going?

CN211276 wrote: ↑Fri Jan 28, 2022 10:11 am

Lindsayt wrote: ↑Fri Jan 28, 2022 8:25 am
Surely how the money is spent is largely down to the management within the NHS?

Not true where Wales is concerned and I would think the situation is similar in England.

The Welsh Government allocates funds to regional health boards, the amount depending on the considered need. The health boards are responsible for the allocation of their funding and have autonamy in their regions. The performance of the health boards is closely monitored by the Welsh Government and issues are brought to the chair and chief executive. In extreme cases the Welsh Government can take over the running of the health board to rectify serious problems. The long and the short of it is government Ministers and not the NHS has overall responsibility.

So, these health boards, how they allocate these funds - is that dependent on whether a Conservative or Labour government is in power at Westminster?

If so, how?

Lindsayt wrote: ↑Fri Jan 28, 2022 10:29 am

CN211276 wrote: ↑Fri Jan 28, 2022 10:11 am

Lindsayt wrote: ↑Fri Jan 28, 2022 8:25 am
Surely how the money is spent is largely down to the management within the NHS?

Not true where Wales is concerned and I would think the situation is similar in England.

The Welsh Government allocates funds to regional health boards, the amount depending on the considered need. The health boards are responsible for the allocation of their funding and have autonamy in their regions. The performance of the health boards is closely monitored by the Welsh Government and issues are brought to the chair and chief executive. In extreme cases the Welsh Government can take over the running of the health board to rectify serious problems. The long and the short of it is government Ministers and not the NHS has overall responsibility.

So, these health boards, how they allocate these funds - is that dependent on whether a Conservative or Labour government is in power at Westminster?

If so, how?

It does not matter who is in power at Westminster. Money is allocated to the devolved administrations and they decide where it goes, health taking a major share. In Wales HBs decide how they allocate their funds, with the Government closely monitoring performance. The Minister is at the top of the pyramid.

With regard to the unfortunate circumstances surrounding your friend I would advise you to write to the local MP. If he is worth his salt he will take the matter up with the Minister who could raise the matter with the regional Health Trust (they are not called boards in England). It would not be a good idea to write to the Minister directly as you would be likely to receive a bland reply from an official advising you to take the matter up directly with the Trust.

Lindsayt wrote: ↑Fri Jan 28, 2022 8:25 am

savvypaul wrote: ↑Fri Jan 28, 2022 12:01 am Have a look at the figures for health spending as a percentage of GDP since 2008, Lindsay.

https://www.statista.com/statistics/472 ... ingdom-uk/

Webpage you linked to does not provide clear info on GDP over the years, nor on spending on the NHS vs GDP over the years. Can you provide a link that does so?

So, if I have a career where I had a reduction in income in 2008 and have since had increases above inflation up until 2020 and the amount of money I have been spending on my garden has been increasing by 1.4% above inflation every year, would you expect my garden to get in a worse state in 2019 than it was in 2009? Simply because the spending on the garden didn't increase as much as my income?

We seem to be looking at a 10 year decline in both GDP and health spending as a percentage of GDP, since 2008/9. To me, that suggests that the funding in real terms has decreased. Even if the spending had remained flat, I would find it hard to believe that the same could be said of demand (ageing population) and costs (new medicines, cost of existing medicines increasing as we now don't have the same buying power / discounts as we enjoyed when we teamed up as part of the EU).





The garden analogy might be the most ludicrous over-simplification that I have ever come across, but I'll roll with it. Let's say that you run a large garden that is open to the public. Demand increases, so you extend your opening hours (but the garden is free to use, so you can't raise additional funding unless you can get it from government), costs of materials increase, part of your estate is falling into disrepair, so you need to do extensive repairs / renovation, 2 of your gardeners are Bulgarian, and they decide to go home because they can't now bring their families to stay with them during the summer, so you have to sub-contract / use agency staff (at least in the short term), which costs more. Unless you were exceptionally inefficient before that, and you were able to drastically improve, then you wouldn't be coping with all that within the budget that you state.

There are examples of good and bad practice within any large organisation. I don't see any compelling evidence to suggest that the NHS is an outlier, in that respect. What I do see is short-sighted political interference, often resulting in false economies. For example, the government's decision to remove nursing bursaries in 2017. This has meant that the service has been unable to attract enough staff, and existing staff have been placed under considerable pressure due to rising vacancy levels, resulting in an increase in existing staff leaving the service - the classic vicious cycle. Costs then increase because the service becomes more reliant on expensive agency staff.

my sister in law is a nurse, has been since 1995. Her take is that the staff exodus over the last 5 years is the biggest issue. Her pay in relative terms has remained fairly static with either no increase a year or a small increase. I didnt pry its not my business what she earns.
The hours and stress that staff are under has risen exponentially because of the lack of staff, everyone from consultants to porters to cleaning staff to anaesthetists, every single department has seen huge reductions in staff. she has called in here in a morning after working nights on numerous occasions, utterly exhausted and close to tears so she can sit and talk to emma for abit of support

Bojo the clown could inject a billion quid today and it would not solve a thing. There are simply not enough bodies to effect a change. It would take a decade to recruit and train enough staff to effect a significant change.

Vinyl-ant wrote: ↑Fri Jan 28, 2022 3:07 pm my sister in law is a nurse, has been since 1995. Her take is that the staff exodus over the last 5 years is the biggest issue. Her pay in relative terms has remained fairly static with either no increase a year or a small increase. I didnt pry its not my business what she earns.
The hours and stress that staff are under has risen exponentially because of the lack of staff, everyone from consultants to porters to cleaning staff to anaesthetists, every single department has seen huge reductions in staff. she has called in here in a morning after working nights on numerous occasions, utterly exhausted and close to tears so she can sit and talk to emma for abit of support

Bojo the clown could inject a billion quid today and it would not solve a thing. There are simply not enough bodies to effect a change. It would take a decade to recruit and train enough staff to effect a significant change.

And the pandemic is speeding up that exodus.

I retired a year after the Brexit referendum. In my last year the impact Brexit would have on the number of nurses was a HUGE concern. It seems the worst fears have been realised. The amounts agency nurses had to be paid to fill in the gaps was also a major concern. My wife used to be friends with an agency nurse who earned an absolute fortune.

The other thing to remember about how much agency staff are paid is that we're talking about their pay AFTER the agency has taken their share from what it's actually costing the NHS to employ them.

Geoff.R.G wrote: ↑Fri Jan 28, 2022 10:22 am If, as is suggested, the money is there where is it going?

£37 billion on a failed track & trace system?

Vaguely back on topic it looks like he's gotten away with it ...................for now, but he's only keeping the seat warm until the next contender thinks the time is right.