Give the NHS a Royal Charter?

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gladders
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#1
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This is an idea one of my friends has proposed as a means of reforming the NHS. Now, he is a Thatcherite, but his idea does seem to have some reason to it, even to someone such as I who is on the whole hostile to undermining the basic tenets of the NHS, that of universal healthcare.

His idea - dismantling the Department of Health, but creating a 'BBC-like' NHS, responsible to Parliament but autonomous and independent of direct ministerial interference, looks like a good means to eliminate the micro-management that currently takes place in the NHS, and potentially reduce administrative burden on doctors enormously. This in itself would free up time and money for them to save lives.

Now I don't know too much about economics, but this ideas appeals, but your good selves might know reasons why it would be bad, or lead to privatisation or collapse in the long run. What do you all think?
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Teaddict
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Yes this is a common sense approach to the National Health Service and something I have supported for some time. Just like the transport infrastructure in Germany, the BBC in Britain and other state provided services in other countries, they should be operated as independent businesses with a public-centric ethos.

In terms of the National Health Service, you give it the same independent as the BBC to ensure that one cannot fiddle and constantly rejig it's organisational structure for political purposes.
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Norfolkadam
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This sounds to me like privatisation by the back door. I am intrigued by the idea but it would be too easy for a government ideologically opposed to a public health service to replace public-sector funding and management with private-sector funding and management if it wasn't directly linked to the government.
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Teaddict
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(Original post by Norfolkadam)
This sounds to me like privatisation by the back door. I am intrigued by the idea but it would be too easy for a government ideologically opposed to a public health service to replace public-sector funding and management with private-sector funding and management if it wasn't directly linked to the government.
IF it has not happened with the BBC in its long history, It is hardly likely for it to happen with the NHS...
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Kibalchich
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(Original post by Teaddict)
Yes this is a common sense approach to the National Health Service and something I have supported for some time. Just like the transport infrastructure in Germany, the BBC in Britain and other state provided services in other countries, they should be operated as independent businesses with a public-centric ethos.

In terms of the National Health Service, you give it the same independent as the BBC to ensure that one cannot fiddle and constantly rejig it's organisational structure for political purposes.
its not a business, its a health service
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PossibleMPP
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(Original post by Kibalchich)
its not a business, its a health service
Face palm inducing comment. An adapted business model would free the NHS from meddling from the government, help them to get their fiscal house in order, and occasionally, like the BBC does, cut down on inefficiencies and streamline their processes, thereby freeing up more money for things such as Doctors, Nurses, procedures, and research.
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Kibalchich
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(Original post by PossibleMPP)
Face palm inducing comment. An adapted business model would free the NHS from meddling from the government, help them to get their fiscal house in order, and occasionally, like the BBC does, cut down on inefficiencies and streamline their processes, thereby freeing up more money for things such as Doctors, Nurses, procedures, and research.
Its not a business.
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PossibleMPP
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(Original post by Kibalchich)
Its not a business.
Are you quite simple?

Let me try to say this at as basic level as humanly possible: Granting a Royal Charter would allow the NHS more autonomy and self-governance and prevent meddling by various governments. Additionally, introducing efficiency ratings and internal functions would lower the costs of the NHS and reduce wait times for patients. The money saved in this (yes business-like manner *gasp*) could be used to improve NHS facilities, conduct research, or hire more doctors and nurses.
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Kibalchich
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(Original post by PossibleMPP)
Are you quite simple?

Let me try to say this at as basic level as humanly possible: Granting a Royal Charter would allow the NHS more autonomy and self-governance and prevent meddling by various governments. Additionally, introducing efficiency ratings and internal functions would lower the costs of the NHS and reduce wait times for patients. The money saved in this (yes business-like manner *gasp*) could be used to improve NHS facilities, conduct research, or hire more doctors and nurses.
Are you simple? Its not a business. It can't be "operated as [an] independent business[es]" because its not a business.
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PossibleMPP
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IGOs, NGOs, charities, Government associated agencies (such as the BBC), etc are not business but they CAN operate in a manner which supports streamlining processes and cost savings. I do hope you are intentionally being obtuse rather than actually being this thick.
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Kibalchich
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(Original post by PossibleMPP)
IGOs, NGOs, charities, Government associated agencies (such as the BBC), etc are not business but they CAN operate in a manner which supports streamlining processes and cost savings. I do hope you are intentionally being obtuse rather than actually being this thick.
I was responding to the post I quoted. Is that too difficult for you to get your head round?
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Kibalchich
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I do think that the NHS needs to be freed from political interference, but comparison with business is stupid. Its not a business and cannot be run as a business. Businesses are run for profits, or in the case of vol sector charities, they are run to be in competition with other organisations. This is not a good thing, it leads to a race to the bottom in order to compete for contracts, leading to a decline in worker's pay and conditions, a decline in morale, a lack of resources and worse care overall for service users.
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Captain Crash
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(Original post by gladders)
This is an idea one of my friends has proposed as a means of reforming the NHS. Now, he is a Thatcherite, but his idea does seem to have some reason to it, even to someone such as I who is on the whole hostile to undermining the basic tenets of the NHS, that of universal healthcare.

His idea - dismantling the Department of Health, but creating a 'BBC-like' NHS, responsible to Parliament but autonomous and independent of direct ministerial interference, looks like a good means to eliminate the micro-management that currently takes place in the NHS, and potentially reduce administrative burden on doctors enormously. This in itself would free up time and money for them to save lives.

Now I don't know too much about economics, but this ideas appeals, but your good selves might know reasons why it would be bad, or lead to privatisation or collapse in the long run. What do you all think?
I like the idea of depoliticisation of the NHS (although, bizarrely the part of the health care reforms that offered this the most was most heavily objected to and dropped) but the idea of a royal charter misunderstands how the NHS works. The NHS isn't (contrary to popular belief) a monolithic organisation. Instead it is essentially a franchise made up of indepedent publicaly owned trusts, which receive payment for services from the government pot.
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PossibleMPP
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(Original post by Kibalchich)
I do think that the NHS needs to be freed from political interference, but comparison with business is stupid. Its not a business and cannot be run as a business. Businesses are run for profits, or in the case of vol sector charities, they are run to be in competition with other organisations. This is not a good thing, it leads to a race to the bottom in order to compete for contracts, leading to a decline in worker's pay and conditions, a decline in morale, a lack of resources and worse care overall for service users.
This post shows a complete and utter lack of understanding on how industry works, how charities work, and outright false statements on how company's and NGOs operate. Let's take a look at some of the low hanging fruit here:

Private sector workers get paid more on average than their government counterparts, this is not even debatable. Private sector workers tend to actually "buy" into their firms culture and again tend to be happier. Pound expeditures produce greater levels of services in the private sector due to much greater bureaucracy, overheads, and duplication of efforts in the public sector.

I would seriously consider taking a remedial economics courses if I were you.
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Kibalchich
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(Original post by PossibleMPP)
This post shows a complete and utter lack of understanding on how industry works, how charities work, and outright false statements on how company's and NGOs operate. Let's take a look at some of the low hanging fruit here:

Private sector workers get paid more on average than their government counterparts, this is not even debatable. Private sector workers tend to actually "buy" into their firms culture and again tend to be happier. Pound expeditures produce greater levels of services in the private sector due to much greater bureaucracy, overheads, and duplication of efforts in the public sector.

I would seriously consider taking a remedial economics courses if I were you.
What a load of old rubbish. I didn't mention the private sector, I'm talking about how the vol sector operates, which is as non-profit businesses. Employees certainly do not "buy in" to the culture IME!

My views come from eight years working in the vol sector and 2 years of being a union rep in the vol sector. I know exactly what happens when vol sector orgs are forced into competition with each other. I don't give a sh*t what your micky mouse economics course told you.
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Kibalchich
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The essential point is that healthcare services do not act in a market in the same way as other businesses. There is a set amount of money budgeted when commisioners put out to tender, and organisations all compete to bid for the highest service level agreements at the minimum costs. This drives down pay & conditions and overall service quality.
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PossibleMPP
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(Original post by Kibalchich)
What a load of old rubbish. I didn't mention the private sector, I'm talking about how the vol sector operates, which is as non-profit businesses. Employees certainly do not "buy in" to the culture IME!

My views come from eight years working in the vol sector and 2 years of being a union rep in the vol sector. I know exactly what happens when vol sector orgs are forced into competition with each other. I don't give a sh*t what your micky mouse economics course told you.
Union rep. Unions had their place once upon a time, now they only succeed in making Western manufacturing and industry uncompetitive. So that explains your contempt for business and utter lack of understanding.
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Kibalchich
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(Original post by PossibleMPP)
Union rep. Unions had their place once upon a time, now they only succeed in making Western manufacturing and industry uncompetitive. So that explains your contempt for business and utter lack of understanding.
You don't have a clue.
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gladders
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(Original post by PossibleMPP)
Union rep. Unions had their place once upon a time, now they only succeed in making Western manufacturing and industry uncompetitive. So that explains your contempt for business and utter lack of understanding.
Has it? Japan and Germany have quite robust union traditions and they're doing fine.
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Old Father Time
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Okay, what If this happened and the NHS did run more independently, but what if they then encountered financial difficulties, they would have to be bailed out by...the government or the banks. If the banks bailed them, this would cause all sorts of problems and the strain on the institution to repay the loan could cause them to charge for providing the health service, or doctors and nurses ect lose jobs. If the government had to bail them, then that means less money to be used for other sectors such as education and that's hardly fair. I say keep it as it is, reduce government spending on silly things like nuclear missiles and the Monarchy and use the money to improve the NHS and improve the health care service provided to the people of Britain.
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