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The problem as i understand the recent changes with consultant contract and Agenda for change is that the bods who thought up the scheme didn't cost it properly, ie consultants working more hours than they were paid for are now actually getting paid. However, junior doctors base salary is pretty low, only really brought up by their pay banding which is now being brought down by horrible distorted on call rotas including having fixed leave. No personal experience but plenty of friends in that situation.

Agenda for change likewise was not costed properly and therefore not adequately funded by government.

On the other hand KPMG and others are making a mint out of this as are the private healthcare providers.

I have a friend who is a GP who has just received a fax by the paymasters running out of money, demanding that they don't do anymore minor surgery in the practice because they won't get paid for it.

The really annoying thing it that no one in government is held accountable. The people at the coal face, clinical staff just get shouted at for breaching the 4 hour waiting time and are not allowed to make the correct clinical decisions for their patients.

Rant over. :angry:

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The really annoying thing it that no one in government is held accountable. The people at the coal face, clinical staff just get shouted at for breaching the 4 hour waiting time and are not allowed to make the correct clinical decisions for their patients.

Well said, Bee Bear.

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Agenda for change is not beneficial for nurses, their yearly basic salary is increased, but unsocial hour pay rate is decreased big time, so there is no option to boast the basic salary by working more night or weekend shifts. So, over all it is not good for nurses!

I don't understand how could possibly someone think that by cutting front worker (nurses and carers) jobs, NHS would financialy benefit???? Instantly, yes... less people to pay at the end of that month, one month! .... but it will cause so much more costs!

Remaining nurses and carers will not be able to provide adequate, or minimal standard of safe care, more intrahospital infections are about to happened, not to mention that by being unable to get on top od daily tasks, more and more tasks are going to be missed, patients will have prolonger stay in hospitals and the most expensive issue from my point of view, the symptoms and possible complications will not be prevented, or recognise on time therefore these treatments of unnecesar complications will cause huge and easily prevented costs.

Bad management, lack of team work within NHS overall is where money is going, and it will continue to be like that until management change something drastically.

It only takes 5p to save NHS ! ! ! !

Perfect Planing Prevents Poor Performance

Edited by sanjaCRO
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Didn't mention 4 hour target.... another most stupid idea anyone could ever suggest !

A&E departments, have the biggest potential out of all departments, to save money for NHS.

But by doing that they need to be supported with highly profesional and skilled team in order to recognise and treat the right symptoms without causing further complications ! But, no, the biggest target in A&E is 4 hour target...

Edited by sanjaCRO
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The gradings may have changed to bandings, and the figures may be slightly different, but I woudn't say things have changed for the better! I work for the NHS and following assimilation to the new Agenda for Change terms and conditions, have now been offered 15% less than I am actually already earning (and a huge number of colleagues are in the same position)! Of course, I won't actually be paid any less (protected pay), just won't get a pay rise until everybody else catches up with me ... in about 2012!!!

Sounds to me like you have a weak staff side representing your staff so the management have easily stiched you up!

But, on the plus side for staff, instead of the government negotiating pay settlements with myriad different staff/grades (divided they fall!) they now have to deal with one large, powerful body of staff. They'll regret that in the long run.

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If NHS hospitals cut 50% of Doctors and Nurses, and cut 50% of cleaners then these savings could be used to award the Executives at the front end of the finances with a decent renumeration for the work they do.

How long are we going to watch the Executives in public services scrape by on measly 150k bonus's each year and low wages of 250k when they could earn much more in private enterprises.

The real problem with the NHS today, is that hospitals are wasting money on treating patients and not addressing the real purpose of a Government Departmen, Job and Wealth Creation.

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The real problem is that the nhs is a huge organisation run like a stalinist state. With an expensive added on attempt at capitalism. If we are running a service that is to benefit people's health and gives staff the chance to have fulfilling careers with decent pay decent hours (ie not working a whole 48 hour weekend and then another full day on top) THEY NEED TO CONSULT THE PEOPLE ON THE GROUND!

The top down approach just doesn't work. Targets just distort the system and make the government be able to go WHOO HOO we did this for X group. Yeah but Y group over there is paying the price, gathering dust in some unsexy speciality.

The government has paid HUGE sums of money for "city consultants" to come in and "fix" things or tell them how to run them. Instead they should have had a consulation with all the people involved in health care, from the people running Strategic health authorities, GP's, practice nurses, receptionists and all hospital staff, down to the porters and cleaners.

If you include people, get them involved in solving the problem, instead of just telling them DO THIS, you harness the creativity of each person, who may have the most brilliant idea of how to solve a problem in a particular area.

But this goverment doesn't like the "little people" being involved. Despite devolution, this governemt, wants to keep as much real power all for itself. Their sense of knowing everything is so tragic and annoying.

Sorry. Rant over. Again.

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The real problem is that the nhs is a huge organisation run like a stalinist state.

Indeed: the NHS is a disaster and almost certainly can't be 'saved' as a government-run operation. The good news is that NuLab seem to be doing everything in their power to destroy it right now.

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I can't understand how we have come to the point of large scale redundancies of front-line medical staff. Health should be a priority. How can we justify other less essential services of we cannot care for the sick.

I work in the NHS (and in the private sector), in dentistry. NHS dentistry has been decimated and is on a slipperly slope to it's final death in 3 years (when money to fund NHS dentistry is no longer ring-fenced).

Personally I think, if it comes down to a simple choice of which services to fund, dentistry is pretty far down the priority list: care of life-threatening illnesses has to come first.

What annoys me is the lack of political honesty. I'd really appreciate it if Gordon Brown came out and said, 'Sorry folks, but we just can't afford XYZ on the NHS anymore, so if you want it, you'll have to pay'. At least then people could prepare. How much worse is it to find out you have a serious illness but can't access care.

I'm sick of telling patients, who ask why they have to wait 6 months to have their filling done, 'Ask Tony Blair'

Another thing, it is true the NHS is carrying so many unproductive members of staff, occupied with targets, performance figures (of other people's work) and policy. Funny how I can work fine without a manager in the private sector, but in the NHS cannot order repairs, supplies, over-ride policy, change my timetable, organise my waiting list, choose support staff or have any control at all over my working practices without the permission of a myriad of managers.

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I'd really appreciate it if Gordon Brown came out and said, 'Sorry folks, but we just can't afford XYZ on the NHS anymore, so if you want it, you'll have to pay'. At least then people could prepare. How much worse is it to find out you have a serious illness but can't access care.

Underlines their policy exactly... 'ignore' what they can’t deal with.

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What annoys me is the lack of political honesty. I'd really appreciate it if Gordon Brown came out and said, 'Sorry folks, but we just can't afford XYZ on the NHS anymore, so if you want it, you'll have to pay'. At least then people could prepare. How much worse is it to find out you have a serious illness but can't access care

If we cannot afford it, then why is the Government giving our money away to other countries in charitable donations, surely the health of our people would come first?.

Also, why would we give 7Bn of EU rebates away, if we cannot afford the NHS?.

Why would we give 7Bn of Eu rebates away if the Government has no money for pensions.

Or is it simply the case that a socialist Government sees the people it rules over as cash cows, Drones for their real purpose of power on a global basis.

To be quite frank, a Government that has taken a country to war on false information, and a Government that orders a reshuffle of the house of lords in the name of equality, but in reality is only interested in installing its own cronies who give large cash paybacks for titles is a Government that should resign before the people begin to march to their door.

The government’s controversial private finance initiative is floundering. Patricia Hewitt’s review of the £1.28bn PFI plan for the Barts and The London hospitals trust, prompted by spiralling costs revealed last December, also raises questions about the whole policy.

Professor Allyson Pollock, head of the Centre for International Public Health Policy wrote in the Guardian:

With 39 PFI hospitals signed up for at a capital cost of £3.2bn and another 41 schemes planned, at a cost of £12bn, the policy is out of control. So why is it that, when the government continually claims that the virtue of PFI is that it “comes in on time and on budget”, runaway costs have suddenly become the most pressing issue? The answer lies in the government’s new “payment by results” pricing regime. The Department of Health’s policy is to privatise NHS clinical services, hence the need for a market-oriented pricing system.

This requires the NHS move from block budgets, based on contracted volumes of planned work, to a system whereby each treatment has a price tag. The price is set to reflect the “average cost” of that treatment across the NHS. And here’s the rub: payment by results has unexpectedly flushed out the true cost of PFI. Using private finance to build a hospital creates a debt, which must be paid to the private-sector consortium over a 30- to 60-year period. This debt, known as the annual PFI charge, is met from the hospital’s operating budget, which pays for staff and patient care.

Since 1991 every NHS hospital has had to pay the Treasury an annual charge for the use of land and buildings. It is therefore possible for each scheme to compare the cost of capital to the hospital before and after PFI. In the case of Barts and the London, the capital cost in 2005 was £8.62m a year. This is the amount the trust must pay the Treasury, which is then paid to the health department and recycled within the NHS system. But under PFI, the cost of capital at the Barts and the London will rise more than eightfold to £67m. The money flows out of the NHS and into the pockets of shareholders and their bankers in the private-sector consortium Skanska Innisfree.

This higher annual cost – £67m compared with £8.62m – creates what is known in the PFI business as an “affordability gap”. This is the difference between what the private-sector consortium charges and what the trust can afford.

The ways in which hospital trusts and the government have sought to bridge this gap in the past is well documented, ranging from selling off land and buildings to reducing services and closing acute and community hospitals, as in Kidderminster and Norfolk. Since Labour came to power in 1997, more than 12,000 NHS beds in England have been lost as part of this policy, and the closures are continuing apace.

A large chunk of the current NHS trust deficits has been generated by the annual PFI charge and by unrealistic expectations about both the income and the savings that the schemes would generate. In the case of Barts, the trust is expecting a £37m increase in income from additional patient care and at the same time must plan for total savings of £22m, or 4.2% of turnover.

But how can a hospital generate more patient treatments and income when it has to close beds, cut services and lay off staff to pay the PFI charge? Without a large injection of public funds the trust will be forced to divert hospital budgets still further from staffing to paying the exorbitant PFI charges.

Take the Queen Elizabeth hospital trust in Greenwich. It is struggling under the weight of a PFI contract that it cannot afford, and managers there estimate that £9m of its £19m deficit is down to PFI. If it defaults on the PFI charge, the government could be presented with a bill for the full £140m bond used to finance the deal.

To date the government’s response has been to blame trust managers – easy whipping boys. But as the trust’s auditors make clear, the Queen Elizabeth has increased its efficiency over the past five years and, when the excess costs of PFI are removed, it actually outperforms the NHS average.

As more PFI hospitals come on stream these problems will be accelerated, compounded by the new tariff system and more austere funding climate. The simple fact is that in the new marketised NHS, the PFI circle cannot be squared with expenditure.

In recent months, the trend of government policy has been to directly privatise clinical services. The halfway house of foundation trusts and PFI hospitals leaves policy too exposed. Once hospitals are fully privatised, the true costs can be hidden under the guise of commercial confidentiality, with the decisions about cuts and closures left to “market forces” and merely endorsed by the independent regulator.

The problems with the Barts and the London PFI scheme are symptomatic of a much wider market-induced healthcare crisis. It is time to commission the full, independent review of PFI that successive Labour party conferences have called for.

Professor Allyson Pollock is the author of NHS plc; additional research by Mark Hellowell

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The risk for the patient I suppose is that at worst you die before you get treatment.

http://www.suttonobserver.co.uk/displayNod...tentPK=14241084

Jobs axe hospital recruits managers

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04:59 - 25 March 2006

A hospital which is axing almost 500 jobs to cut costs has come under fire after it emerged it was advertising for risk assessment managers.

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I can't understand how we have come to the point of large scale redundancies of front-line medical staff. Health should be a priority. How can we justify other less essential services of we cannot care for the sick.

I work in the NHS (and in the private sector), in dentistry. NHS dentistry has been decimated and is on a slipperly slope to it's final death in 3 years (when money to fund NHS dentistry is no longer ring-fenced).

Personally I think, if it comes down to a simple choice of which services to fund, dentistry is pretty far down the priority list: care of life-threatening illnesses has to come first.

What annoys me is the lack of political honesty. I'd really appreciate it if Gordon Brown came out and said, 'Sorry folks, but we just can't afford XYZ on the NHS anymore, so if you want it, you'll have to pay'. At least then people could prepare. How much worse is it to find out you have a serious illness but can't access care.

I'm sick of telling patients, who ask why they have to wait 6 months to have their filling done, 'Ask Tony Blair'

Another thing, it is true the NHS is carrying so many unproductive members of staff, occupied with targets, performance figures (of other people's work) and policy. Funny how I can work fine without a manager in the private sector, but in the NHS cannot order repairs, supplies, over-ride policy, change my timetable, organise my waiting list, choose support staff or have any control at all over my working practices without the permission of a myriad of managers.

Dentistry is crazy expensive in the private sector, i had a filling the other day 100 pounds!! With the low cost airlines, you can go to France and have it there for the same price

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I thought they were expensive, until I used a solicitor.

80 quid for an email with two lines in it.

180 quid an hour.

Who is making this money, is it the solicitors or the firms that employ them.

Same with Dentists, do they make this money or are there vast overhead costs such as insurance and administration?.

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'Same with Dentists, do they make this money or are there vast overhead costs such as insurance and administration?.

Dentistry is a very expensive business to run. Remember, in that filling fee, you're paying the dentist, the nurse, and the receptionist. There are considerable overheads such as: property, disposables, materials, cross-infection prevention costs, capital investment for equipment, servicing of equipment, collection of special wastes.

Dentists have to pay the GDC about £500 a year to stay on the 'register' and about £800 a year in compulsary indemnity insurance.

If a dentist doesn't own the practice, typically 50% of their earnings are paid to the practice owner who pays the costs listed above.

If you have a crown, you're also paying the technician and remember, crowns are made out of expensive things like gold, platinum and paladium.

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Also, let's face it, would you want to spend all your days staring into other people's mouths for 20k a year?

It is amusing though, that NHS dentistry has been destroyed by a _Labour_ government. The Tories would never have been allowed to get away with it.

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My Dentist is the business, Private, 200 quid an hour, works very fast. And his helper is a blonde russian who would pass as a super model. Having her looking into your eyes, patting your brow whilst holding one hand is well worth the money, and the pain :D:D:D I would go every day if I could afford it.

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