Competition in the NHS

One of the things to be open to outsourcing:

wheelchair services for children

Anyone care to have a stab at an argument about why this should be an NHS, directly provided, monopoly?

27 thoughts on “Competition in the NHS”

  1. So Much For Subtlety

    Because Socialist Wheelchairs are lovingly crafted with care and warmth?

    Unlike those made by Fascists who just want to sell product and so make money.

  2. If this happens I guarantee that within 5 years:
    The cost of wheelchairs for kids will have come down
    The design will be cool
    The weight will come down
    There will be innovations we can’t even think of.
    Users will be happier.

    But hey, somebody will have made money. Argh! Don’t let it happen. It’s evil.

  3. So Much For Subtlety

    Bilbao boy – “If this happens I guarantee that within 5 years: …. The design will be cool”

    Well that’s a reason to prevent competition then. The last thing we want is for everyone to want one.

  4. If this refers to a body which co-ordinates the disbursement of taxpayer funds for the provision of wheelchairs bought from the private sector, then actually I see no reason why this particular body needs or should be outsourced. An entity disbursing funds and coordinating approval of products that would qualify for such funds appears to be a natural monopoly.

    Maybe I am wrong.

  5. What are “wheelchair services” anyway?

    Are they talking about actual wheelchairs (and they’ve just added “services” on the end because it’s fashionable)? Or is it services like the car needs every 12,000 miles (how often do wheelchairs have to go in for an MoT)? Or is it teaching people how to use wheelchairs?

    Or is it producing cheery adverts to tell us to be nice to people in wheelchairs?

  6. Labour questioned the policy, which the shadow health secretary, John Healey, said was “not about giving more control to patients, but setting up a full-scale market”.

    What the hell does he thing a “full-scale market” brings?

    To add to Bilbao Boy: NHS glasses for kids don’t look like NHS glasses for kids in the 70s.

    Actually, I think this is quite smart. Demonstrating the results of privatisation in heart surgery is much harder than with wheelchairs.

  7. Conversely I expect this to happen like rail privatisation: costs to the taxpayer will increase, while service remains at or just below the minimum mandated level.

  8. What is a ‘wheelchair service’? This from DoH:

    “Whizz-Kidz is a charity that was set up in 1990 to provide disabled children with essential wheelchairs and other mobility equipment to help them lead fun and active lives.

    Disabled children in Tower Hamlets were facing waiting times of over two years for powered wheelchairs.

    Whizz-Kidz started working with NHS Tower Hamlets in 2007 to help them deliver a more child focused wheelchair service for the disabled children in the borough. Since that time, the partnership has grown and the charity continues to deliver the wheelchair service for children and young people up to 25 years old. Co-located with the PCT’s adult service, Whizz-Kidz therapists – experts in paediatric mobility – assess all children and young people referred to the service and prescribe mobility equipment that take account of their educational, social and clinical needs, enabling them to lead independent, full and active lives.

    Working together Whizz-Kidz and NHS Tower Hamlets have cleared the waiting list and increased the number of children who benefit. Whizz-Kidz have been able to provide high specification and more appropriate equipment than could be purchased by the PCT alone.
    User satisfaction has improved and children receive wheelchairs, on average, within six weeks of referral.

    Expanding Any Willing Provider to wheelchair services would enable organisations like Whizz-Kidz to provide similar services to disabled people in other areas helping them to lead a better quality of life”

    Two thoughts occur:

    1) Anyone who objects to the practical steps that delivers better wheelchairs more quickly at no extra cost for disabled children is a baby-eating lunatic coward.

    2) Where’s Arnald?

    http://healthandcare.dh.gov.uk/wheelchair-services/

  9. “Wheelchair services” doesn’t just mean wheelchairs, provision of.

    It means a huge staff of people vaguely connected in some way with wheelchair provision, its design, sourcing, delivery, and – especially – governance and regulation.

    Every one of these people has a generous salary, a bonus, private health insurance, a car allowance, an office, a laptop, and an inflation-proof final salary pension.

    These are the people who don’t want it outsourced.

  10. “If this happens I guarantee that within 5 years:
    The cost of wheelchairs for kids will have come down
    The design will be cool
    The weight will come down
    There will be innovations we can’t even think of.
    Users will be happier.”

    Although they need to need Hindi to understand the instructions, and the bolts keeping it from falling apart will be left only hand-tight by the Banagladeshi children, their tearstains still visible on the aluminium, who have assembled it in working conditions so bad they’ll probably qualify for a wheelchair soon enough themselves.

    Sorry, I forgot – seatshops are good for you if you’re dirt porr, not white and don’t live in Europe! Nobel prize winning economists are queuing up to lecture you you on how all these are in fact your comparative advantages in a global labour market!
    Was the “their tearstains still visible on the aluminium” overkill?

  11. Surreptitious Evil

    Was the “their tearstains still visible on the aluminium” overkill?

    That’s the whole point of controlled oxidisation of the aluminium frame – unless you are weeping sulphuric acid, stains won’t show.

    seatshops“, I assume if I was less of a cynical git, was an ironic reference to the manufacture of wheel-chairs</b. Or not, especially given "porr“.

  12. Martin

    These are 3 different questions:
    One
    Competitive tendering tends to improve goods and services or get the same for less cost.
    Two
    Remember, the tenderer is responsible for controlling the supplier. Government should get good at that. There are many factors which affect price and it is surprising how much effort companies put into innovating when the pressure is on. There are, and I hope this isn’t a surprise, hundresd of millions of honest, imaginative people labouring away doing things well. We do not all eat babies. And, as I like to say, we all have grannies, aging parents and children and live in society.
    Third
    With regard to poverty there are 2 great schools of thought.
    Aid is the answer
    Trade is the answer
    Here is not the place to argue. Tim has interesting posts on this matter. Trade does not imply exploitation.

    Just a question, before the Bangladeshi child was being exploited by my wheelchair manufacturing company, what exactly was his situation?

  13. Bilbao Boy,

    “Competitive tendering tends to improve goods and services or get the same for less cost.”

    Blah, blah, blah, blah, blah, blah, blah, God Bless all here while the nightingale sings in the raspberry bushes, etc., etc., etc. Do yourself a favour. Learn the words of the song, ‘There is nothing like a dame’ from ‘South Pacific’. It’s a bit catchier than what you usually seem to repeat to yourself.

    But I see you’ve gone off on one. Sigh.

    “Remember, the tenderer is responsible for controlling the supplier. ”

    Remember, we’ve got a boatload of one-sided protofascistic public liabilities in the UK lumped together under the title ‘The Private Finance Initiative’. Without wishing to seem callow and juvenile (if only because I know my interlocutors in this space live in the real world and not the unreal one I live in, where Fry’s Peppermint Cream bars grow on trees and the streets are paved with candy floss), there seems to have been crap all attempt by those tenderers – wasn’t that the title of a TV show that starred Tony Curtis and Roger Moore? – to control the suppliers. But we’ll let that pass. I’m rolling with it.

    “Competitive tendering tends to improve goods and services or get the same for less cost.”

    See ‘Roger Moore’ above.

    “There are many factors which affect price and it is surprising how much effort companies put into innovating when the pressure is on” –

    Anyone for cold fusion technology? The only cold fusion likely to be taking place in the UK next winter is elderly couples freezing to death in each others’ arms because they can’t afford to top up the fucking prepayment gas card. On the other hand I don’t suppose that really matters, if only because nobody who really matters, such as politicians, journalists and those who read Tim’s blog, has a prepayment gas meter. It does happen, you know. Please let’s not go there.

    “There are, and I hope this isn’t a surprise, hundresd (sic) of millions of honest, imaginative people labouring away doing things well.”

    And not getting paid enough for it either. One of the travesties of modern British thought is the idea that we must all be sensitive to the needs of the wealthy and powerful, the darlings.

    “We do not all eat babies”

    Speak for yourself.

    “Just a question, before the Bangladeshi child was being exploited by my wheelchair manufacturing company, what exactly was his situation?”

    Just an answer, I suppose he wasn’t likely to be doing something that would cause him to end up in a wheelchair.

    Hasta la vista, baby.

  14. So Much For Subtlety

    Martin – “Blah, blah, blah, blah, blah, blah, blah, God Bless all here while the nightingale sings in the raspberry bushes, etc., etc., etc.”

    Sticking your fingers in your ears and refusing to listen is not a very grown up thing to do.

    “Remember, we’ve got a boatload of one-sided protofascistic public liabilities in the UK lumped together under the title ‘The Private Finance Initiative’. ”

    Protofascist? Great. It is mid term hols is it? That is kind of his point though isn’t it? It was up to the government to control those deals and they didn’t.

    “Without wishing to seem callow and juvenile”

    Too late!

    “Anyone for cold fusion technology? The only cold fusion likely to be taking place in the UK next winter is elderly couples freezing to death in each others’ arms because they can’t afford to top up the fucking prepayment gas card.”

    Britain is more likely to have cold fusion next year that a single old age pensioner couple will freeze to death because they can’t pay for gas. But, hey, the real world – who needs it? Right?

    “It does happen, you know.”

    No it doesn’t.

    “Just an answer, I suppose he wasn’t likely to be doing something that would cause him to end up in a wheelchair.”

    Actually he probably was. Children working in the Third World are at high risk. Sweat shops are comparatively safe. If he was selling papers on the street for instance, he would be at greater risk of ending up in a wheelchair. Even if he was farming. So how about answering the damn question but thinking this time?

  15. Thanks ‘So Much’ for your reply to Martin

    Saves me time. Shan’t put an adjective to it, but at school, many years ago, the level of debate was considerably higher even amongst the more intellectually challenged members of the sixth form.

    Cutting to the chase..

    The Bangladeshi kid might have been picking through a rubbish heap, and certainly would have less of everything that matters and more of everything that they and nobody would want even for their enemies. Ask the millions of Chinese who have moved on and the rest of the millions that will catch up over the next 20 years. Done on trade. It’s incremental and it is real, even if I don’t like their government and think that they have a zillion miles to go in terms of personal liberty.

    Sometimes I wonder if caring people don’t really care about real poverty or whether the poor are merely a tool to castigate ‘baby eaters’.

    I travel to the UK regularly and am always surprised that somehow one third of the population is getting some sort of benefit in what is one of the richest countries in the world. I believe something is fundamentally wrong with that and others don’t.

    Poverty exists amongst a small new underclass which require a whole new social, educational analysis, but otherwise the ‘poverty’ I read about ain’t poverty.

    Having less than others is not poverty.

    Problems are not necessarily poverty.

    That society has failed many people is obvious, but the answer is not doing more of the same, is it?

    However, I shall take note of fuel poverty (look at the definition, it ain’t poverty either, its an invented political message measurement and means very little) and make sure my 83 year old pensioner father doesn’t die of cold (which is surprising given the level of global warming I thought we were due for). I can always send him him a fiver. Calm my conscience. Might even go to see the old bu**er. Many more will die from loneliness and boredom than poverty and cold.

    When the dead couple are found next spring in an advance state of decomposition, ask where the kids, nephews, brothers and sisters and even neighbours were.

    When we ask the state to take over family responsibilities that is what happens. But that is a whole new debate.

  16. More unintelligence here:
    “Britain is more likely to have cold fusion next year that a single old age pensioner couple will freeze to death because they can’t pay for gas. But, hey, the real world – who needs it? Right?”

    http://www.ageuk.org.uk/pagefiles/2013/excess_winter_deaths_report_oct10.pdf

    As for the fuel poverty comment in the next post; pffffft. You know nothing, obviously.

    “…ask where the kids, nephews, brothers and sisters and even neighbours were.”

    They’re too busy exploiting bangladeshi kids in order for them to afford the latest haircut.

    That’s what your thinking means. Fuck the vulnerable, make profit.

  17. “Just a question, before the Bangladeshi child was being exploited by my wheelchair manufacturing company, what exactly was his situation?”

    Just a question, what was your company doing before the Bangladeshi child was exploited by you?

  18. Wow! I really struck a nerve!

    So Much For Subtlety,

    My apologies if my quotation from Joseph Wambaugh’s ‘The Black Marble’ went over your head. Then again, perhaps it went in one ear and out the other. This never happens to me, if only because I have my fingers in my ears. I agree with you; sticking your fingers and refusing to listen is a very silly thing to do when you’re being presented with a new idea. Bilbao Boy, on the other hand, was recycling ideological boilerplate with a healthy side order of cant. It was about as new as next Sunday’s ‘News Of The World’.

    “It is mid term hols is it?’ – How the hell would I know? I’m 41 years old.

    “That is kind of his point though isn’t it? It was up to the government to control those deals and they didn’t”

    No, he didn’t make that point. He made a sweeping generalisation about the tenderer always controlling the supplier. That’s what he said. I don’t know if if it’s mid term hols or not, but where I went to school they taught us how to read.

    “Britain is more likely to have cold fusion next year that a single old age pensioner couple will freeze to death because they can’t pay for gas. But, hey, the real world – who needs it? Right?”

    Arnold has already called you out on that one to the extent that nothing you write should ever be taken seriously again. Thank you Arnold. For reasons that are no business of yours, I am very familiar with the conditions that the UK’s elderly have to endure when it comes to heating their homes in winter. They’d have a thing or two to say to you about what happens in the real world, you patronising prick.

    “No it doesn’t.” – Yes, damn you, it certainly does.

    “Sweat shops are comparatively safe” – Och, I’d thought I’d seen it all, but this one can fart through his fingertips. Next!

    Bilbao Boy,

    “Shan’t put an adjective to it, but at school, many years ago, the level of debate was considerably higher even amongst the more intellectually challenged members of the sixth form.”

    Wow, you must be really unaccustomed to being challenged, which is all the more reason to challenge you, of course. I bet you’re a world champion at keeping your corporate peons in line.

    “The Bangladeshi kid might have been picking through a rubbish heap, and certainly would have less of everything that matters and more of everything that they and nobody would want even for their enemies.”

    You say that with such certainty, while I only see the theology of ideology. I pity your blindness.

    “I travel to the UK regularly and am always surprised that somehow one third of the population is getting some sort of benefit in what is one of the richest countries in the world.” –

    This promisingly reflective start to what degenerates into an ideological harangue – and, given that you sound so much like a prosecutor at a Chinese showtrial, I bet that when they come in you’ll be the first in line to don one of those green jumpsuits and start waving the Little Red Book, if only because you think doing so will help you save your own skin – proceeds from the misconception that the UK is in fact a rich country. I’m here all the time, and my corner of it is not rich and has not been so for many years. The reason for that is straightforward – without seeking the people’s consent, Parliament has consistently enacted policies which have occasioned a gulf to grow between rich and poor. I don’t have the exact figures to hand, but if memory serves the UK’s national average wage is, I think, £21,000 pa. One might as well be in indentured servitude as have a low wage job in the UK these days (and before you think you can patronise me, yes, I’ve got one, and no, my qualifications probably really are better than yours) . This is sustainable when food and energy are cheap. It is not sustainable when they are expensive. This is going to have to change. One of the joys of seeing Rupert Murdoch bending over for a spanking from the mere mortals of the Culture, Media and Sport Committee (though what beneficial involvement he might have had in the development of culture or media or sport is anyone’s guess) is that it is perhaps a view of the shape of things to come. After 20 years of a world without Soviet Communism, people are tired of hearing how free trade is good for them when their jobs are being sent overseas, and of how foreign ownership of utilities is good for them when the prices just keep going up. Something’s got to change, which usually means something’s going to change. Libertarianism and neoliberalism are officially both as old as yesterday’s socks. Off into history with you! Begone! Keynes rules – OK!

    “I shall take note of fuel poverty (look at the definition, it ain’t poverty either, its an invented political message measurement and means very little” –

    Spending 10% of your income on energy? When you’re on contribution based Jobseekers Allowance of £54/week? And electricity going up by 10 per cent and gas by 19 per cent? I might expect HRH The Duck of Edinburgh not to know how to top up a gas card, but I absolutely refuse to engage in a debate on this matter with someone so obviously detached from the workings of the real world.

    “When the dead couple are found next spring in an advance state of decomposition, ask where the kids, nephews, brothers and sisters and even neighbours were.” –

    Bilbao?

    I don’t know about you, Arnold, but I think we’ve got the buggers where we want them.

  19. Martin

    Just who is patronising who(m)? Nothing like getting your aggression in first. I am glad you are highly qualified. Sorry if my qualifications are not good enough. What a lot of nasty ranting conclusions about me. At least you haven’t got me where you want me. Almost certainly not a nice place. Think

    “Competitive tendering tends to improve goods and services or get the same for less cost.”

    Hardly a sweeping generalisation. It doesn’t actually contain the word ‘always’ but ‘tends’. Not sure where it is contentious either.

    Get ready. Fuel poverty (as defined in the UK) is also going to get considerably worse. The current subsidies to renewable sources are going to add a lot more than the recent 18% Scottish Power (a Bilbao company actually) hit their customers with. Carbon tax policies are going to create real anguish. Other policy decisions are also going to make it worse. The greens are responsible (in Germany and in the UK) although I’ve only heard one or two mea culpas so far. Monbiot is in serious danger of having a Damascus moment. Corporates with energy-based production which compete in a world market will be moving out. Jobs will be lost, so not some individuals will doubly suffer. Protofascists?

    Different decisions on energy sourcing and policy could bring down the bills substantially with all other elements remaining the same.

    What struck me about the Age UK report was the general vagueness of the threat and the tenuous tie to poor energy access. Cold kills, but anyone who has worked with the elderly knew that, years ago. It kills in falls in the street and very, very, importantly winter bugs make the rounds and get elderly people with lung problems. Living in cold (and particularly damp) makes it worse, but the bugs do for us even when we have adequate heating. It’s seasonal and comes with the cold. That’s why the flu jab campaigns happen. The figures for 2008/9 were worse? It was a lousy winter much worse than the year before. Got an ageing population too.

    But, being a rich country, having decided the problem exists and the investment will make a difference, the UK has the funding in place. If fuel poverty is such a problem, my question is why are so many people not using the funds? The problem for policy implementation is not money but lack of take up.

    ‘One in three eligible people in later life do not claim Pension Credit.’ and that apparently triggers fuel benefit!

    How many of those 2 million people (out of the 3,5 million elderly identified as living in fuel poverty) really have no family members who could and should make sure that they are in reasonable conditions by making use of the money that is available? All of them? I don’t believe it. Does nobody care anymore ?

  20. Arnald

    ‘Just a question, what was your company doing before the Bangladeshi child was exploited by you?’

    My company used to manufacture the wheelchairs in Newcastle. But imported chairs were undercutting us by 38%. Energy costs were on the up. Our raw materials, aluminium in particular, were hitting new highs, supplies were disrupted by strikes and labour costs were fixed. Absenteeism due to illness especially at the time of the World Cup was over 7%. Went bankrupt. Set up on my own. Designed a new chair, looked for manufacturers and actually it wasn’t Bangladesh but Vietnam. Now we sell them to the NHS for 42% less than my old company. I didn’t want to close but..

  21. “Absenteeism due to illness especially at the time of the World Cup was over 7%. Went bankrupt. Set up on my own”

    All of which is known in the business world as ‘risk’, I believe. You wouldn’t be doing it unless you want to get rich, or can’t work with anyone else, or can’t do anyone else. I cry no tears for you, and will be back to the fray tomorrow evening.

    BTW, I imagine there might be a guy who could help you with the aluminium problem, name’s Tim Worstall. There, that might just be one problem solved for you already.

    And if your time is so precious and so valuable, why are you wasting it posting blog comments? I thought you go-ahead entrepreneurial types spent every waking hour thinking about the next deal. When you’ve got dealmakers who want to be Dostoyevsky, it’s no surprise that the country’s going down the toilet and a third of the population’s on benefits.

  22. Martin

    ‘All of which is known in the business world as ‘risk’, I believe. You wouldn’t be doing it unless you want to get rich, or can’t work with anyone else, or can’t do anyone else.’

    I understand risk and accept it. But, wow, my motivations seem to be way beyond your comprehension.

    What a warped view of entrepreneurs/business people. Multi-dimensional people exist. At least in my case, you are so far out it’s amusing. In fact your view is so simplistic, it’s fascinating.

    Could you believe that for me
    a) getting rich is not a priority?
    b) it is a personal satisfaction that my presence is requested in non-remunerated, non-profit organisations?
    and lots more but I don’t want you to blow a fuse

    Nah, doesn’t fit the narrative.

    ‘When you’ve got dealmakers who want to be Dostoyevsky, it’s no surprise that the country’s going down the toilet and a third of the population’s on benefits.’

    Oh? It’s my obligation now is it. Yes siree, back to the pit face for me.

    Time. I make time for what I want. I’ll even take a holiday this year. If you don’t mind. Next up, I’ll finish the book I’m reading with The Best of Peter Green in the background. Glass of wine too if I’m lucky.

    PS
    Tim’s in scandium.
    PPS
    I have never had a bankruptcy nor manufactured in England
    PPPS
    One of our businesses is a non-profit workshop integrating ex-druggies back into work
    PPPPS
    Next one up is peer-to-peer lending (like a credit union). Bugger all in that for me, but it has an interesting social dimension, I get to work with really interesting people, it’s innovative and by-passes banks (you’ll probably like that bit)

  23. Bilbao Boy,

    Sorry I couldn’t make our date a couple of nights ago. Got caught up in something else.

    “Just who is patronising who(m)? Nothing like getting your aggression in first. I am glad you are highly qualified. Sorry if my qualifications are not good enough. What a lot of nasty ranting conclusions about me. At least you haven’t got me where you want me. Almost certainly not a nice place” –

    Good moaning style, probably derived from being unaccustomed to hearing people disagree with you.

    “Hardly a sweeping generalisation. It doesn’t actually contain the word ‘always’ but ‘tends’. Not sure where it is contentious either.” –

    See ‘Private Finance Initiative’ above.

    “Get ready. Fuel poverty (as defined in the UK) is also going to get considerably worse. The current subsidies to renewable sources are going to add a lot more than the recent 18% Scottish Power (a Bilbao company actually) hit their customers with. Carbon tax policies are going to create real anguish. Other policy decisions are also going to make it worse. The greens are responsible (in Germany and in the UK) although I’ve only heard one or two mea culpas so far.”

    No, the Greens are not responsible, or at least not solely responsible. Also responsible are avaricious energy suppliers and gutless governments in thrall to the idea that something called ‘competition’ can exist in the provision of services which are always of the same nature, which always perform the same functions, which are always produced in the same way and at the same locations, which are always consumed in the same way and at the same locations and which always travel down the same pipes and copper wires into your home regardless of whoever you happen to be paying to provide them for you. It’s like having a market in bread in which both Tesco and Greggs were active but in which the bread was only ever the same type of brown wholemeal loaf and you had to commit yourself to one or other of the retailers for a minimum of 28 days. The day is going to come quite soon when the public will turn against the current system and demand re-nationalisation, and quite rightly. There is no such thing as a market in gas and electricity. What does exist in the UK is an entirely ersatz market in the price of gas and electricity, a business model which can only work in times of low demand. The current model is itself nothing but an expression of ideology, the very ancient British ideology held by our Establishment that the British people must not be permitted to own anything in common, and have no common interest around which they can rally and challenge the Establishment; and if the Establishment can trouser some dosh in the process, all the better. It suits our Establishment for us always be atomised and at each others’ throats. Chinese and Indian expansion are unlikely to reduce demand for the forseeable future. The only long-term effect that privatisation has had is that it has been made more difficult for people to buy the necessaries of life – which I’m sure you’ll agree is itself a form of tyranny – while our craven politicians have spastically parroted the trope that you can always change supplier; not the most creative response to a crisis.

    “Different decisions on energy sourcing and policy could bring down the bills substantially with all other elements remaining the same” –

    So do you agree that that re-nationalisation should be an option on the table and that these decisions could be made equally well under public ownership? Or are you just another braying right-wing donkey who brays ‘They work for us’ (they – MPs – don’t actually work for us but for and on behalf of Parliament, a fine point that those braying tight-wing donkeys who’ve memorised that one quote from Edmund Burke would be shocked to learn that Burke would have been in complete agreement with)?

    “But, being a rich country, having decided the problem exists and the investment will make a difference, the UK has the funding in place. If fuel poverty is such a problem, my question is why are so many people not using the funds?” –

    I would suggest re-reading ‘The Crossman Diaries’. When serving as the first ever head of the DHSS in the 1960’s, Crossman was startled to learn that the staff in his department deliberately made it difficult for people to claim the benefits to which they were entitled, a form of disenfranchisement. From today’s ‘Journal Of The Law Society of Scotland” –

    “MPs in the House of Commons Work and Pensions committee have hit out at the firm responsible for testing whether benefit claimants are fit to work, accusing it of causing “fear and anxiety” and providing a service “below the standard” required of it. Atos Healthcare, which processes around 11,000 benefit claimants each week, was also criticised over the number of rejected benefit claims which are then subject to costly appeals.

    The committee’s report, published today, said the poor standard of service offered by Atos had had contributed significantly to the widely felt mistrust of the whole process… the scale of the challenge should not be underestimated.”

    On the estimated £50 million annual of processing rejection appeals, the report continued: “The pressure on the Tribunals Service has also resulted in a significant delay for claimants before appeals are heard, causing stress and anxiety for claimants and their families.”

    Labour MP and committee chair Dame Anne Begg added: “There has been trauma for some people with mental health problems and learning difficulties, sometimes making them ill. There have been too many face-to-face interviews, when a person’s conditions could have been determined more easily”

    I think that answers your question. Organisational cultures can be difficult to change regardless of whether the organisation is public or private.

    “How many of those 2 million people (out of the 3,5 million elderly identified as living in fuel poverty) really have no family members who could and should make sure that they are in reasonable conditions by making use of the money that is available? All of them? I don’t believe it. Does nobody care anymore ?”

    Of course not. They’ve been encouraged to be atomised and to go for each others’ throats.

    “What a warped view of entrepreneurs/business people” –

    But one certainly derived from very long and painful experience of dealing with them.

    “Could you believe that for me
    a) getting rich is not a priority?
    b) it is a personal satisfaction that my presence is requested in non-remunerated, non-profit organisations?
    and lots more but I don’t want you to blow a fuse”

    Couldn’t care less really, but I wouldn’t fancy your chances of staying in business for too long.

    “Yes siree, back to the pit face for me”

    Well, coal mining might just be the answer to our energy problems. It might even buy you a bit of street cred when you get that green jumpsuit.

    “Time. I make time for what I want. I’ll even take a holiday this year. If you don’t mind. Next up, I’ll finish the book I’m reading with The Best of Peter Green in the background. Glass of wine too if I’m lucky” –

    Is this a blog comment or a Schweppes advert?

    “PS
    Tim’s in scandium.”

    Oh for God’s sake grow a sense of humour.

    “PPS
    I have never had a bankruptcy nor manufactured in England”

    I suppose someone has to keep Bangladeshi children off the streets.

    “PPPS
    One of our businesses is a non-profit workshop integrating ex-druggies back into work”

    If it’s non-profit, how can it be a business? Are you another that’s sucking on the taxpayer tit and calling it the Third Sector?

    “PPPPS
    Next one up is peer-to-peer lending (like a credit union). Bugger all in that for me, but it has an interesting social dimension, I get to work with really interesting people, it’s innovative and by-passes banks (you’ll probably like that bit”

    I get to work with really interesting people as well. Many of them have been maths and engineering graduates who can’t get jobs at a time when we’re told there are skills shortage in these sectors. Sometimes, you just don’t know who to believe.

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