When did you last go through passport control when you left the UK.? It doesn't happen.
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So why don't you answer the other parts of the argument posted? The fact that spire just drop you back into the NHS when things go wrong and you need an intensive care bed and long term critical care. Or the fact that spire or other private providers pay nothing towards the cost of training doctors surgeons nurses etc.No no no. I've heard this excuse before.
It's down to how the contracts are structured and currently (admittedly) it seems they are often structured very badly indeed. Cleaning services are outsourced now and yet you see crap on the floor all the time. Either the contract doesn't adequately reward cleanliness and penalise dirtiness, or someone in the NHS is not doing their job calling the cleaning company to account. Private companies will always seek to minimise costs - to cut corners even - in order to maximise profits. It's what they do and it's a good thing; it's why capitalism - for all its flaws - is the only system we know of that actually works. So to work in a public service context, you have to be very specific about what you are contracting for and what you are not, and the rewards and the penalties. Then it works. Clearly this is the case because the entire private sector outsources all sorts of things. You do not see this level of push back about privatisation anywhere in the private sector! It's simply a lame excuse those ideologically hell bent on 100% state ownership put forward in order to try to muddy the water.
To answer your specific example, Spire would not get to pick and choose what sort of jobs they want. They'd be given a contract to perform say 10,000 hip operations and get paid (in stages) 30 million quid for it. Of course there would have to contractual provision for things it can't do - exceptions. And those would have impact on the level of reward it receives. The details are unimportant for this discussion. The important bit is that privatisation can be made to work and the idea that it cannot work in public services organisation is a complete smoke screen.
Chippy_boy
Well-Known Member
So why don't you answer the other parts of the argument posted? The fact that spire just drop you back into the NHS when things go wrong and you need an intensive care bed and long term critical care. Or the fact that spire or other private providers pay nothing towards the cost of training doctors surgeons nurses etc.
There's nothing to reply to really. These are non-arguments.
If the cost to the NHS of doing a procedure is higher than getting someone else to do the same work to the same or better standard, then in principle it makes sense to get someone to do it.
If they need NHS intensive care afterwards then that's no different to if the NHS did it and then they needed NHS intensive care afterwards. Not that 3rd parties don't have their own intensive care facilities mind you. So all of that can be catered for in the outsource contract.
Training is also irrelevant. The NHS has people to train either way. In fact their training costs would come down (or at least be lower than they otherwise would be) if some of the outsourced work is done by people who were trained elsewhere. The NHS would need fewer qualified staff if more work is done by third parties. So they'd save money on the procedures and reduced training costs as well.
When did you last go through passport control when you left the UK.? It doesn't happen.
There is a mechanism of tracking people because airlines have to submit who is on their flights. Before you fly you need to add your passport details which is trackable against arrest warrants for example. That is how plod always turn up if you are a criminal on the run trying to leave.
The question is, should we or can we be bothered to do this for someone who hasn't paid their medical bills? And also if someone refuses to pay do we chuck them in prison at more cost until they do and what if they can't? I don't think health migrants or whatever are really that big of a deal to warrant any action. We are perhaps talking of solving a problem that costs £100M at a cost of £99m.
In non-emergency treatment this could all be solved by asking for a deposit refundable or contributed towards payment for treatment or obviously proof of insurance. That is what happens in the US.
The Light Was Yellow Sir
Well-Known Member
Where do you think spire get their surgeons from? There’s a reason all the private hospitals are in the same towns as the nhs ones.There's nothing to reply to really. These are non-arguments.
If the cost to the NHS of doing a procedure is higher than getting someone else to do the same work to the same or better standard, then in principle it makes sense to get someone to do it.
If they need NHS intensive care afterwards then that's no different to if the NHS did it and then they needed NHS intensive care afterwards. Not that 3rd parties don't have their own intensive care facilities mind you. So all of that can be catered for in the outsource contract.
Training is also irrelevant. The NHS has people to train either way. In fact their training costs would come down (or at least be lower than they otherwise would be) if some of the outsourced work is done by people who were trained elsewhere. The NHS would need fewer qualified staff if more work is done by third parties. So they'd save money on the procedures and reduced training costs as well.
PannickAtTheDisco
Well-Known Member
When did you last go through passport control when you left the UK.? It doesn't happen.
you have to have your passport scanned at the gate, and the police look at passenger lists to go and arrest other suspects anyway, would just be added on.
grunge
Well-Known Member
you have to have your passport scanned at the gate, and the police look at passenger lists to go and arrest other suspects anyway, would just be added on.
Just added onI Hah. to improve the systems to do what you want is proibably hundreds of millions of pounds to install and christ knows how much to run yearly. As I mentioned earlier in the thread, the systems dont even time stamp peoples time/date of entry/exit.
stonerblue
Well-Known Member
per month I pay more than enough. Considering previous generations have clearly paid in nowhere near enough to justify their current care (hence the shortages), then I don't see why I should foot the bill in increased taxes for them to get it free, because if they've paid in enough to cover their care then you wouldn't need to raise my taxes.
And when one of your family requires urgent medical care ?
PannickAtTheDisco
Well-Known Member
And when one of your family requires urgent medical care ?
you pay it back in income assessed contributions
Chippy_boy
Well-Known Member
I don't agree at all that the two are mutually incompatible.Core services will always be cherry picked or private firms will be compensated with public money to take on the more ‘unprofitable’ cases. Private firms take on Health services with the objective of making money. If I was a shareholder of such a firm I would expect this to be their objective. There is nothing inherently wrong in this I just do not believe that the profit motive works in Health services or indeed in Police or Fire services. The primary objective of a Health service should be the care and well being of the citizens it serves and not the financial well being of its shareholders. The two are mutually incompatible.
In fact quite the opposite. Private enterprise brings a sense of commercial imperative to do more for less, which EXACTLY what the NHS needs. The trick is to make sure the outsource contracts are framed in such a way that the private companies actually deliver what is required of them and not seek to maximise profits (which is fine) whilst not doing what they are supposed to be doing (which is clearly not).