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Can you imagine the cognitive dissonance that goes on in someone's head that could bring them from being a nurse to being a Tory MP? Who hurt you, Anne?

I don't know what ACA's are. Google will only give me Obama's Affordable Care Act results.

My point still stands. Whether or not it's a good long term policy, getting private companies to provide aspects of public services is cheap stopgap to deliver services. It is not the same as dismantling a free at the point of delivery universal health system and trying to kill people.

I'd be interested in seeing the sources you're referencing for the claim that private health providers will only be accountable to shareholders - and properly understanding what you actually mean by that.

getting private companies to provide aspects of public services is cheap stopgap to deliver services.

Can you source that (cheap)? My understanding of the whole point of these contracts is that they are eye-wateringly expensive which is why they appeal to private companies.

I think the point about only being accountable to shareholders is exactly what it sounds like, its the only thing a private company is obliged to do, and is often done at the expense of customers (c.f., the railways, thames water etc etc etc)

http://www.bbc.co.uk/news/business-41152516 (one thing about thames water)

Apparently the wiki was changed to read "former" director.

(edited out in case of false accusation)

getting private companies to provide aspects of public services is cheap stopgap to deliver services

Why does the US spend more per capita on health care than every other country, then? Surely they should be rolling in these savings. The US government actually spends more the Canadian government. The US government is effectively subsidizing a for-profit system at a cost higher than a nationalised system.

For the record, I don't doubt there are areas in which private companies can be used to save money. I mean, the NHS shouldn't really be investing in its own paper mills. But the idea that private = cheap/public = inefficient is false. Nonetheless, this, in many cases, seems to be the grounding for public private partnerships.

The Dutch system is a strong government controlled mix of minimum mandatory private cover where people on low incomes get the minimum cover fees refunded and high rate private (you can pay for extra cover) and tax funding.

There the discussion of minimum cover VS private is also ongoing, as the high rate private payers don't contribute as much to the minimum cover, which is for all citizens and the pots are running lower. Cover also needs to be adjusted regularly as it's part of the general budget.

It seems to me that private can be an option without necessarily worsening cover, the Dutch waiting lists etc. are way shorter than here.

But private cover can make things needlessly complicated and reform of the NHS by cutting management and empowering local hospitals/trusts etc. to run their own metrics and hiring (because general statistics can be worse than useless, they can harm improvements) etc etc may be a better option than going for a state-controlled private system.

That is assuming we trust the government not to go full USA private on us :/

So Jeremy Hunt now has to fuck up social care in addition to health care.

If anyone thought the Tory take on the NHS wasn't ideological, I'd like to know your reasons. Surely in any other version of this story he'd be out of a job? Instead he's been given more responsibilities.

It doesn't strike me as earth shattering news, given that the most recent major legislation in this area was the Health and Social Care Act 2012.

Can you source that (cheap)?

No. But just to be clear I mean in the short term. Logically paying on a per-use basis (for want of a better phrase) has to be cheaper in the short term than borrowing tonnes of money, paying interest, working out how to use the money, then commencing a program of massive systemic investment that goes all the way down to educating young people. It's like taking an uber for a trip vs buying a car and driving yourself.

To me "only being accountable to shareholders" can be read two ways. Which is why I asked.

a) repetition of the statement of fact that a companies first duty is to the shareholders. Therefore, share price and paying dividends are likely to be a high priority, as opposed to helping people*.

b) there is planned to be some other special carve-outs for private health providers that makes them not subject to the same levels of regulation / rules / laws / etc. that NHS Trusts are. That is obviously very different and would be of serious concern.

*or hitting semi-arbitrary politically dictated targets and lubricating the management consultant gravy-train, depending on your level of cynicism.

Rumours (which are also being reported by the BBC) are he refused to leave and demanded the expanded portfolio. And May gave in.

^ this is almost exactly what I came here to post

I found a really good breakdown explaining this which I'll look for and post. iirc the main thing is actually the admin burden of the system. As an after thought I wondered if had almost turned into a Keynesian system of sorts.

The US system is nuts though, and so deeply scewed against the less well off. From my limited experience if you've got decent healthcare you get much better service than the NHS. However, it's not cheap and the bewildering choice you have is a double edged sword. There is clearly over treatment - which no doubt adds to the cost. Pretty sure there was an issue with Virgin doing this a while back.

EDIT: Here is is: https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp 25% is related to admin.

I pretty much agree with you accept for the last point of making us like the US.

IMO there is a clear distinction between using private companies to carry out work and moving to a near fully private insurance system no longer free at the point of use.

Sometimes I wonder if people really grasp how totally different our systems are.

Happy for everyone to bombard me with quotes from all the Tory MPs who've unequivocally stated a desire to do so.

The US system is nuts though, and so deeply scewed against the less well off. From my limited experience if you've got decent healthcare you get much better service than the NHS.

I disagree, under the highly privatised systems if you can afford it you get more healthcare but not better healthcare. As your link shows the US system is full of rip offs. People with top rate insurance get massive over treatment, with unnecessary and often damaging interventions or over subscription of drugs. The USA spends double per person than we do but health outcomes are markedly lower, for example their life expectancy is 2-3 years lower than ours.

This graph from OECD illustrates the difference in outcomes. I don't know why the UK data has flat lined at the high end. My guess it is the effect of increasing privatisation via PFI under Labour, 're-organisation' under Andrew Lansley and marketisation under Hunt.

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Having given the matter some further thought, May capitulating doesn't strike me as earth shattering news either.

@hugo7 because ive tried replying but it keeps breaking ive tagged you.

I see what you mean about distinction between the two. I totally meant the first one: i.e. companies first priority is share price and paying dividends/future growth. Providing care and a service that is patient focus would become the realm of the niche care provider.

Also, apologies, my mistype, I meant ACO's (accountable care organisations)

heres an explanation of them from a very pro source and probably hoping to be one.
https://www.kingsfund.org.uk/publications/accountable-care-organisations-explained

Also for further reading if you can be bothered on private companies behaviour when given NHS contracts:
https://www.theguardian.com/society/2017/dec/29/richard-branson-virgin-scoops-1bn-pounds-of-nhs-contracts

And a current doctor discussing what ACO's run by private companies is likely to look like on the frontline.
https://twitter.com/drphiliplee1/status/950107458600624134

Im leaving focus as focus when it should be focused because it wont post again if i edit it and ive tried about 5 times today already to answer.

Also also, I think any Tory MP coming out and saying we should private the NHS publicly is potentially signing his way to the dole queue in the current climate. The NHS is a sometimes maligned, often not the most efficient but still very much loved entity in the UK and to suggest out loud that it should be made paid at point of treatment would be a vote killer currently. all they have to do is continue to undermine it in the background and when its on its knees and unable to cope, privatisation could look like a good thing.

then the tories could reduce taxation once paying for the nhs is off the public purse and all of Mays mates gets more money in their pockets.

god i sound like the craziest conspiracy theorist.

If you are a conspiracy theorist then so is Noam Chomsky...he said pretty much the same :)

Never seen in the same room.

#obviousilluninatiisobvious

Ooooh we have a very famous lfgss member then... ;)

This. Is. An. Outrage.

http://irishpost.co.uk/burglar-sues-shop-owner-injuring-genitals-break/

On a more serious note there is some interesting content in here (from the over-55s)

https://www.demos.co.uk/project/citizens-voices/

Some random comments:

• You go to A&E on any night of the week and a lot of the people going in are on first name terms with the staff because they’re going in time and time again, because really they should be in a care home of some description.

• I think it probably started in the 80s, I’m biased, but I can remember Thatcher saying ‘there’s no such thing as society, only the individual’. And I think the balance changed a lot.

• Our society has totally lost respect. It’s just got no respect for anyone or anything.

• Bring back hanging […] I tell you what, it would stop…this rise in acid attacks. It takes one person to hang and it would stop.

• At work we have an equality and diversity team, so I get what they’re doing, don’t get me wrong, it’s brilliant stuff. But there’s an inordinate amount of resources for the needs of two people, when there are 3000 people overall. So think it has to be proportionate.

• You have to have a percentage of immigrants. To build your society. But it does need some control over it. Personally, I would go for a system as I say, other countries have, where you have to show what you are going to bring to the country. Just make it fairer.

• There’s a lot of people in positions [of power] judging aspects of life that they’ve never experienced. They said we’re all in this together, and they’ve got their noses in the trough ripping off the expenses and it’s us lower beings that have got the runt of it. It’s always been the case.

• Rees-Mogg comes across a tough Tory, but I think he’s clued in to more everyday things.

• I’d vote for Boris Johnson, because at least he’s an idiot and we can have a laugh. I know he’s probably completely out of touch and he is a bit of a buffoon. But he is quite smart, and I would much prefer him than anyone else I can think of.

• My son was absolutely livid [about Brexit]. He texted me to say, “I hope you are happy now”.

• When me granddaughter goes to dancing class, she’s only four and she’s not allowed to go in the same dressing room for people above five without having a chaperone there. There’s got to be chaperones there. Now, that’s come from European law, it’s come from that.

• It just seemed a little bit futile for so many lives to have been lost in wars, to have been absorbed by the same people that we were fighting against. I know that’s history, but what was the point of it all if we were just going to give into it?

• I was in Italy a couple of years ago and I was in a hotel, and the waiter served curly cucumbers, and he looked at me and he smiled and he said ‘Yes, it is only the British that have straight cucumbers’. What it tends to be is: because we are a very honourable nation, what everybody says, we have to get along with the rules, we actually play by the rules. Nobody else does!

• We have a farm, and so many of our workers are from Eastern Europe. I don’t know what I’ll do if they stop coming. They won’t stop coming, will they?

You get the picture...