Scale Of Nhs Financial Crisis Revealed Amid Looming Staff Cuts

[interestrateripoff]

http://www.telegraph.co.uk/health/nhs/10610648/Scale-of-NHS-financial-crisis-revealed-amid-looming-staff-cuts.html

NHS hospitals face having to cut staff and services amid the worst financial outlook for almost a decade - with almost half forecasting they will end the current financial year in debt, records show.

Board reports covering all 145 hospital trusts in England disclose that 44 per cent expect to end the year in deficit - with a combined “black hole” of more than £330 million between them.

Senior NHS officials said organisations are struggling to cope with pressures on Accident and Emergency (A&E) departments, with hospitals recording their highest ever levels of emergency admissions in the run-up to Christmas.

Many organisations are spending heavily on agency staff, with a 60 per cent rise in the total bill for locum doctors in the past three years, with doctors being paid up to £1,500 a shift.

Considering the NHS budget is around £100bn a £330m blackhole seems rather tiny especially when the govt is borrowing £10bn-£15bn it seems most months.

I know we have some Drs on here are things in the NHS reaching crisis point with budget issues and poor management?

[Executive Sadman]

the NHS Is a moneypit. Cant be reformed. Must be destroyed and rebuilt from scratch.

[Liquid Goldfish]

All that graph shows is that we decided to double spending on the NHS after 2001 to bring us into line with other developed countries.

the NHS Is a moneypit. Cant be reformed. Must be destroyed and rebuilt from scratch.

[EUBanana]

The US spends more on healthcare than most (all?) but arguably has quite poor results for it.

Spending more money just because someone else spends more money is an idiots policy... There's a bit more to it than that.

[Olebrum]

Controlled demolition. Carving it up and selling it off to ones chums.

[Frank Hovis]

It needs widescale reform.

Can Gerry Robinson fix the NHS was a good and intelligent approach to it.

[crashmonitor]

All that graph shows is that we decided to double spending on the NHS after 2001 to bring us into line with other developed countries.

The doubling has largely gone on new buildings, staff wages and administration. All of which has had no effect on productivity and output, it has barely changed. Worrying since the numbers needing treating will rise precipitously in the coming years.

[spyguy]

The doubling has largely gone on new buildings, staff wages and administration. All of which has had no effect on productivity and output, it has barely changed. Worrying since the numbers needing treating will rise precipitously in the coming years.

True.

The NHS just appears to be an organisation that provides a large number job for stroppy, half wits.

We had a 'No Cuts' march a few years. It was staffed by 100s of fat, dumpy middle aged people who worked at the hospital.

The big health trend of the last10 years is the continued reduction in smoking.

The NHS contribution to that is a large number of ineffective advertising campaigns and a legion of bossy bints (and they are mainly bints) running the stop smoking scheme.

Compare that expense to the more effective routine - e-cigearettes.

[interestrateripoff]

All that graph shows is that we decided to double spending on the NHS after 2001 to bring us into line with other developed countries.

The only problem is what is classed as health care spending from country to country varies, ie old peoples homes in some countries get lumped in with health care spending.

[ARIMA]

the NHS Is a moneypit. Cant be reformed. Must be destroyed and rebuilt from scratch.

Doesn't that just show when labour was elected I.e. 1997.

[winkie]

The more people there are, the less healthy they are, meaning the wrong diets, leading to obesity, the more addictions there are, stress and mental health problems there are...the older we are getting meaning life is prolonged, the more people on long-term medication and the more procedures demanded and drugs developed....the higher the NHS will continue to cost......exponentially....unless certain costs are shared, cut or better managed.

[crashmonitor]

Doesn't that just show when labour was elected I.e. 1997.

It also shows how the Nation is ageing. Unbelievable that in 1970 the real spend in today's money was only 18 billion and now is heading for sevenfold in real terms.

Hence we see the classic health Ponzi scheme in formation, no claims being made in the early years upon the first generation of NHS contributors, but bust when the claims come in. No chance for those at the bottom of this particular Ponzi scheme.

Edited February 1, 2014 by crashmonitor

[crashmonitor]

http://www.hscic.gov.uk/article/3453/Average-NHS-pay-up-one-per-cent-last-year-and-nearly-nine-per-cent-in-four-years

The rise was most precipitous during Labour's term it has flattened lately and is just under 30k per head. But add on final salary schemes and the real cost will be closer to 45k.

[Habeas Domus]

If that chart included PFI costs if would go off the top of the scale, in fact it would bust out the top of your computer window and stop halfway up the wall.

[Habeas Domus]

£301,343,154,097. That is the total that the UK's public sector will pay in existing Private Finance Initiative repayments.

http://www.theguardian.com/news/datablog/2012/jul/05/pfi-contracts-list

[Liquid Goldfish]

The US spends more on healthcare than most (all?) but arguably has quite poor results for it.

Spending more money just because someone else spends more money is an idiots policy... There's a bit more to it than that.

Yes, uniquely amongst developed countries we can provide a heath service by only spending 5% of GDP. All the other countries need to spend 9%+. But we are special!

EDIT - using USA as a comparison is a straw man - as I'm sure you are aware.

Edited February 1, 2014 by oldsport

[Liquid Goldfish]

True.

The NHS just appears to be an organisation that provides a large number job for stroppy, half wits.

We had a 'No Cuts' march a few years. It was staffed by 100s of fat, dumpy middle aged people who worked at the hospital.

I'm sure the staff who work in the health service of other countries all look like the cast of ER.

[Billy soy]

Is this not due to nearly half of all hospital beds now being filled with pensioner dementia patients? with the numbers growing year on year.

[Liquid Goldfish]

One of the huge historic benefits of the NHS was the ability for it to control costs, the ability to stop the medical profession from sucking in every last penny as people sought health and prolongation of life.

However, Labour threw much of that out of the window as it sought to create another client group that owed its welfare to them.

I'm pleasantly surprised at how much the NHS has improved. Back in 2001 when we had the big debate on how to spend the extra money on health I was very much in favour of the option of following the French model. But we stuck with the NHS model. I have no particular love for the NHS model but I think it's much better than many like to believe.

I know it's a cliche - but it's true - that there inevitably will be waste when you suddenly have an enormous increase in spending and try to reverse decades of working on a shoestring.

I saw a graph recently that showed that productivity has fallen in the NHS - but only slightly. Most of the increase in spending has produced greater "output", which presumably means more scans, operations etc.

I'm not sure salaries have increased as much as you say. I know GPs got a very big rise - and nurses got a rise as well (which I fully supported). But did hospital doctors and other staff also get a rise?

I think a lot of the increase has actually gone on facilities, equipment and drugs as well as lots more doctors and nurses..

Edited February 1, 2014 by oldsport

[frozen_out]

I'm pleasantly surprised at how much the NHS has improved. Back in 2001 when we had the big debate on how to spend the extra money on health I was very much in favour of the option of following the French model. But we stuck with the NHS model. I have no particular love for the NHS model but I think it's much better than many like to believe.

I know it's a cliche - but it's true - that there inevitably will be waste when you suddenly have an enormous increase in spending and try to reverse decades of working on a shoestring.

I saw a graph recently that showed that productivity has fallen in the NHS - but only slightly. Most of the increase in spending has produced greater "output", which presumably means more scans, operations etc.

I'm not sure salaries have increased as much as you say. I know GPs got a very big rise - and nurses got a rise as well (which I fully supported). But did hospital doctors and other staff also get a rise?

I think a lot of the increase has actually gone on facilities, equipment and drugs as well as lots more doctors and nurses..

This is propaganda gearing up for privatisation. It's following exactly the same pattern as the Royal Mail propaganda. The service is actually fine, and delivers good value for money. There have been stories recently about A&E at bursting point, but A&E has always been at bursting point. You could argue that A&E should be busy anyway, otherwise you'd have staff sat around doing nothing.

If re-elected I think the tories will privatise thee NHS in the next parliament.

[ChumpusRex]

I'm not sure salaries have increased as much as you say. I know GPs got a very big rise - and nurses got a rise as well (which I fully supported). But did hospital doctors and other staff also get a rise?

I think a lot of the increase has actually gone on facilities, equipment and drugs as well as lots more doctors and nurses..

There was a big increase in hospital doctors' salaries, but this has largely been a temporary effect:

The new consultant contract gave existing consultants an approximately 30%-40% pay rise (depending on local negotiations). Effectively, it turned a consultant's salary from a flat rate national scale, to a per hour rate. The govt had expected pay parity for 40 hours, and were anticipating a significant salary saving as they anticipated typical working weeks of 32-35 hours. The actual working weeks that they ended paying were 50-60 hours.

While older consultants may well be stuck on 50-60 hours contracts, newly hired consultants will typically be hired on 40 hour contracts, and sometimes this might be as low as 32 hours (particularly in London where it is easy to recruit staff). In practice, surveys of actual working hours, suggests that new consultants are "expected" to work about 52 hours. New consultants are often a lot poorer than the older consultants, unless as increasingly the case, the older consultants are having their hours trimmed back.

A similar thing, but for different reasons happened with junior doctor salaries. In this case it was concern over length of working week, which quite commonly was around 72 hours (and could exceed 84 hours per week, to cover periods of annual leave, staff sickness, etc.) There was typically only token payment for the hours worked outside 9-5.

This was renegotiated, so that JD would receive a salary based on a 40 hour week, and then an "out of hours supplement" if actual working hours exceeded certain thresholds. The supplement was very low below 48 hours a week, bute rapidly rose with work hours and work intensity, reaching 100% of base salary if 56 hours per week or more were worked. (It was actually a lot more complex than that, and included things such as rest brakes, maximum length of uninterrupted breaks, various statistics, etc.)

For about 5 years after the new JD contract came in, pretty much all junior doctors were paid for 80 hours, because it was impossible to get their working weeks below 56 hours. Now that hospitals are used to shorter doctors hours, and have hired more juniors, then it would be pretty unusual for a JD to be paid for more than 56 hours, and many jobs are now paid at 48 hours or below. The result has been a massive reduction in JD salaries, and a big cost reduction for the NHS (as it is a lot cheaper to hire 6 JDs at 48 hours/week, than 5 at 56).

[Billy soy]

PFI costs?

[Executive Sadman]

All that graph shows is that we decided to double spending on the NHS after 2001 to bring us into line with other developed countries.

Your point being? other countries waste billions to achieve negligible results so we should too?!

The entire planet spends too much on healthcare and is beholden to a greed driven medical-industrial complex which grew like a parasitic cancer under labour.

ive never understood simply offering inane national comparisons as a line of debate. Its seems to be the prime argument for HSR too. France has fast trains, so we should as well!

WTH?! If france wants to waste billions on underused projects let them. Its not a reason in of itself for us to do the same here.

[dinker]

Bureaucracies always act to increase their own power;

http://en.wikipedia.org/wiki/Iron_law_of_oligarchy

[Executive Sadman]

This is propaganda gearing up for privatisation. It's following exactly the same pattern as the Royal Mail propaganda. The service is actually fine, and delivers good value for money. There have been stories recently about A&E at bursting point, but A&E has always been at bursting point. You could argue that A&E should be busy anyway, otherwise you'd have staff sat around doing nothing.

If re-elected I think the tories will privatise thee NHS in the next parliament.

So why should having their monopoly dissolved and having their market opened up to competition worry them?