13 comments on “Timmy Elsewhere

  1. Go on then, ACO: what are your views on, say, the volume/complexity of work done by ISTCs (as paid for) or the re-admission rates following elective surgery?

    Humour me. You being so funny, an’ all.

  2. What are your views on the 10% of people who enter NHS hosp[itals getting sick from their visit?

    Can you explain how a personal think like ill health benefits from the additional layer called government?

    Can you tell me why it’s wise to subsidise people who don’t look after their health and thus incentivise them, funded by punishing people who work and thus make them less likely to work?

    Can you tell me why I should put up with the awful producer captured mess called the NHS?

  3. The reduction in waiting times will be a combination of actually getting things done quicker and fiddling the system.

    Time between consultation and operation has been gamed by delaying when you see the consultant.

    Waiting times for GP appointments were dictated to be no more than 48 hours. My local surgery simply stopped letting people make an appointment for more than 48 hours ahead.

  4. The greatest failing in the NHS is the utter defeatism of it’s pledge to provide health care from cradle to grave.

  5. ACO, I ask again: what are your views on ISTCs – specifically as related to the casemix of surgery performed – given Le Grand’s opinion of them? Come on now… we want an informed debate, don’t we?

    And spare me the Daily Mail sub-journalism shite. I am more than well aware of the problems on general wards – none of which are decently explained by that very poorly-written article. I’d be the first to suggest that UK healthcare would benefit from greater de-centralisation – but that’s an altogether different thing from chanting vague platitudes about the “market”. Simply slagging off us NHS grunts ain’t a subsitute for a workable healthcare policy.

  6. what are your views on, say, the volume/complexity of work done by ISTCs (as paid for) or the re-admission rates following elective surgery?

    a) if guaranteed-minimum-volume contracts aren’t being met, that reflects incompetent planners, not incompetent ISTCs.

    b) readmission rates for ISTCs aren’t substantially different from in-house surgery, but – just as right-wing idiots cherrypick every single example of a bad thing happening in NHS care as a savage indictment of the NHS’s evils – anti-market campaigners do the same for bad things that happen to ISTC patients.

  7. “that reflects incompetent planners”

    Right, we’re getting somewhere… do you think the (very much NuLAb enforced – a la the NHS supercomputer, PFI etc) ISTCs were JUST what your local infirmary needed in order to improve (and bear in mind that even simple procedures can become horribly complicated)? Because Prof Le Grand does – despite his complete lack of operating experience.

    As for re-admission rates: DoH are being coy, and there ain’t that much data. But I know of several Orthopaedic surgeons who are extremely unhappy.

  8. Nobody is going defend Le Grand, then?

    I’ll admit the re-admissions question is slightly loaded (aside from the scanty data) – the point being that (by and large) ISTCs are undertaking simple elective procedures, and leaving the tricky/messy stuff for the NHS. If the use of private sector has improved waiting lists in the UK, it is by virtue of the extra (and expensively brought) capacity… it’s got little to do with the pseudo “choice and competition” so beloved of La Grand. The bloke talks bullshit – and citing him in defence of market mechanisms is equally suspect.

    Tim adds: You seem to have missed the important point. England used (some) market mechanisms. Scotland and Wales did not. England improved more at lower cost than Scotland and Wales. Ergo, some market mechanisms imrpove things at lower cost than not market mechanisms.

  9. “England used (some) market mechanisms”

    Like what? ISTC referrals, “Payment-by-results”, the rubbish that is Choose-and-book?

    Pseudo-market mechanisms, more like. They might excite Le Grand Professor, but scratch beneath the surface – and these things/processes are pretty much a joke. I work in surgical admissions: simple, low risk stuff gets bumped to the (poor value) ISTCs – triple-As and the rapidly exsanguinating get done in-house. The magic c-word is “capacity”, not “competition”.

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