8 thoughts on “The remuneration of doctors and nurses should be decided by the market, not politicians”

  1. Posted 27/04/2017 at 13:41 | Permalink

    For there to be a market customers have to have a meaningful choice of supplier, and employees have to have a choice of several employers for choice to be meaningful. There is no real market because only a few “customers”can afford to choose the expensive private sector as an alternative to the NHS. There is little choice for employees either because the NHS is the one big employer with just a few jobs in the private sector.
    Labour was a useless failure. Why would anybody sensible expect Labour to be an effective privatiser creating real competition and value for money?

    Labour introduced ‘autonomous’ hospital PFIs. These hospitals cost 2-3 times as much per service and the very secret contracts are carefully written to ensure these cannot be closed down because of their built-in ever rising costs to the public purse. See “How PFI is crippling the NHS” https://www.theguardian.com/commentisfree/2012/jun/29/pfi-crippling-nhs
    In other words cheaper and more value for money hospitals now have to be closed down to feed the cuckoos in the nest.

  2. Posted 27/04/2017 at 21:39 | Permalink

    Tell us more about this “National Beer Service”. Will it be free at the point of use?

  3. Posted 28/04/2017 at 08:12 | Permalink

    Fredrik, yes, but there’ll be a waiting list. And there’ll be a points-based system to assess how much beer you need.

  4. Posted 28/04/2017 at 13:54 | Permalink

    Kristian,
    Yes, I think you are right, shame though as the current tax regime on booze is somewhat regressive and the thought of people richer than me subsidizing my beer consumption was quite appealing for a moment there!

  5. Posted 29/04/2017 at 12:00 | Permalink

    Nah, it’ll never work. Far too much like common sense. Plus, sadly with my limited experience working for a CCG, considering the staggering level of financial dysentery that they suffered from – one would seriously hope that this lack of control is not replicated across all CCG’s – I would surmise that there would be an even greater lack of uniformity of service and indeed quality of service across the regions, as some that are better run provide better remuneration packages compared to others.

    The problem, as we all know deep down, is not one of money. It is one of leadership and it is one of lack of vision. Too many at CCG level do the bare minimum not to get fired, are clockwatching to reach pension age and have lost the concept of service, as to what they are really there for. All the money in the world will not solve it unless there is real leadership and real vision as to what the service is supposed to be about and driving towards achieving that. And, these monolithic organisations in the end all become self licking lollipops.

  6. Posted 29/04/2017 at 13:51 | Permalink

    At this very time, we have a situation with labour rates in the NHS are being price-controlled by ‘other means’ that will end in tears.
    Beginning April this year any ‘agency’ nurse, the ad hoc temporary staff that are brought in to supplement the trust’s own regular employees, are having their earnings taxed at source under one of Blair/Broun’s ‘innovations’, IR35.
    Now most employees don’t realise this but ‘basic’ rate tax isn’t actually 20%…and the nurses realised this when compared to their pre April earnings,a drop by 50% or thereabouts.

    Now, the reason for this previously fairly well renumerated ‘temp’ market is simply there are not enough nurses around to fill all the shifts within a normal working week.
    Which is why the rates moved up to the point that there were enough nurses to cover the shifts as a type of overtime.
    Classic supply and demand!
    Now what has happened is that many will simply not bother to turn up for , after tax, is about twice minimum wage, and many, many others who hail from other lands will move to where it pays better.

    The net result is even fewer nurses…

    And the remainder are now holding out for higher gross hourly rates to cover the increased business costs of higher taxation.

    The net result will be a combination of less service from the NHS and higher labour costs which will inflate the NHS call on government money..

    I have said before, it takes a special type of stupid to be a politician….

    PS Do I need to create a campaign to get G&Ts on the NBS?

  7. Posted 01/05/2017 at 20:28 | Permalink

    Kris- The factor you perhaps missed is the supply side. One of the problems in the UK is that the number of training places for medics/nurses is highly restricted -it does not respond to market demand – and such courses are highly over-subscribed. This is because governments control the NHS and subsidise the training it offers and thus they restrict the number of places in order to control the cost.
    As a consequence, we have the crazy situation where medical training courses can expand the number of places, but only for non-UK (and non-EU) applicants, who pay the full cost.

    There is little purpose in leaving pay to the market while at the same time leaving the supply levels to be controlled by the government.

  8. Posted 05/06/2017 at 10:11 | Permalink

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