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The NHS
Mar 10, 2024 18:05:39 GMT 1
Post by staffordshrew on Mar 10, 2024 18:05:39 GMT 1
Yes, could be that It's just a dose of realism. The NHS isn't broken due lack of funding, the model itself no longer works as it was originally intended and no amount of extra funding will put that right. If it hadn't become such a sacred cow and political football we would have moved away to a more insurance based system as used in most developed countries around the world. It is, however, a sacred cow. So any political party who ever want to form a government better find a way to work with it. Realistically any suggestion of the demise of the NHS would condemn any party to eternal opposition.
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Post by martinshrew on Mar 10, 2024 19:23:31 GMT 1
Yes, could be that It's just a dose of realism. The NHS isn't broken due lack of funding, the model itself no longer works as it was originally intended and no amount of extra funding will put that right. If it hadn't become such a sacred cow and political football we would have moved away to a more insurance based system as used in most developed countries around the world. 110%. It's a completely outdated notion to expect a fully functioning NHS to work in the 21st century. Too many people, living for too long, with too complex problems.
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Post by Pilch on Mar 10, 2024 20:19:02 GMT 1
and there we have it 110% of realism
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The NHS
Mar 10, 2024 20:19:17 GMT 1
Post by staffordshrew on Mar 10, 2024 20:19:17 GMT 1
It's just a dose of realism. The NHS isn't broken due lack of funding, the model itself no longer works as it was originally intended and no amount of extra funding will put that right. If it hadn't become such a sacred cow and political football we would have moved away to a more insurance based system as used in most developed countries around the world. 110%. It's a completely outdated notion to expect a fully functioning NHS to work in the 21st century. Too many people, living for too long, with too complex problems. Go ahead all of you and put yourself up for election, see how far you get Then find a way to keep the NHS and improve it.
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Post by Worthingshrew on Mar 10, 2024 20:40:37 GMT 1
It's just a dose of realism. The NHS isn't broken due lack of funding, the model itself no longer works as it was originally intended and no amount of extra funding will put that right. If it hadn't become such a sacred cow and political football we would have moved away to a more insurance based system as used in most developed countries around the world. It is, however, a sacred cow. So any political party who ever want to form a government better find a way to work with it. Realistically any suggestion of the demise of the NHS would condemn any party to eternal opposition. Not sure about that any longer. Most people realise that throwing more money without s9me change isn’t going to work. I worked in NHS for 19 years and I have no more solutions than anyone else, other than to say we need a cross-party Royal Commission to look at all possible funding models across the world and come up with a model which will work for UK. People who can afford it are going privately due to the long waiting lists, and it should not be that way. I think the Tory party are quietly encouraging that and have been for years.
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Post by martinshrew on Mar 10, 2024 20:50:15 GMT 1
110%. It's a completely outdated notion to expect a fully functioning NHS to work in the 21st century. Too many people, living for too long, with too complex problems. Go ahead all of you and put yourself up for election, see how far you get Then find a way to keep the NHS and improve it. Think back to the year 2000, not that long ago, the last time the NHS probably functioned effectively. - Mental health barely existed in the form of treatment like today. - Autism, Aspergers and everything in-between wasn't a major form of treatment like today. - How much longer are we living now? - How many more people are there now? - How much more complicated are illnesses now? The NHS as a free to access service simply does not function, and is completely unfit for purpose. The sooner we realise that throwing money at a failing institution won't fix it, the better. Total reform is required, and the move to a paid for efficient private service is much required; even if it is scoffed at by many, it's works in plenty of other countries.
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Post by staffordshrew on Mar 10, 2024 21:06:27 GMT 1
I knew I should have set up a new thread about Rhod Gilbert's cancer care film. Utilising the NHS thread just rattled the cages of the NHS bashers who had been quiet since April 2023. Sleep soundly again now guys, there, but for the grace, none of the above will happen to you and yours. But for those who do need it, they will be thankful for the NHS.
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Post by Feedo Gnasher on Mar 10, 2024 23:11:38 GMT 1
Already had to go private for my dentist these days…
It may well be that the NHS in its traditional model is now unsustainable, but it would be nice to see a serious attempt to reform/fix it. Simply chucking money into it doesn’t work as has been proven, but running it into the ground does not make the argument for private care.
NHS fans need to get a grip though, it’s there to save lives, and it will always save lives, but it’s not saving as many lives as it should, and access to effective care and treatment is at an all time low. For every story about how effective and well cared for somebody’s been, there’s an equivalent story about how the NHS has let someone down, through cancelled appointments and operations, being left in corridors, lack of dignity and such like. It shouldn’t be sacrilege to point this out.
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Post by neilsalop on Mar 11, 2024 8:00:59 GMT 1
It's 12 months since my missus was rushed to RSH when her appendix burst. We were extremely lucky in that an ambulance arrived within 10 minutes of the call by 111. We were lucky that the A&E consultant picked up on her condition in time and had her rushed to surgery. We were lucky that a pre-cancerous growth was found in the offending appendix and the further tests were carried out within a couple off weeks.
We should not have to rely on luck. The NHS is the best thing that any government has ever given this country and it needs to be protected, funded and allowed to flourish.
The USA has an insurance based healthcare (sic) system and it is appalling. People die over there because they can't afford health insurance, go bankrupt due to the co-pays and deductibles they have to pay even on the best insurance, pre-existing conditions are not covered. Wives are forced to stay in abusive marriages because they don't have their own health insurance. Employers give zero benefits to their staff apart from health insurance, which is often as basic as they can buy. Part-time staff don't get coverage at all. The cost of healthcare in the US as a %age of GDP is around 14%, in the UK it is around 8%. In the UK everyone is covered, in the US around 8% of the population has no healthcare coverage (26 million people).
The Commonwealth Fund rates the healthcare of 11 of the richest countries, we used be number 1 back in 2010 with the US tailing back in 11th place. We are currently 9th. 14 years of under-investment and privatisation have dropped us 8 bloody places, That is shameful. The US is still in 11th place. In Australia (which is currently in first place on the table) they pay 2% of their earnings to the Medicare Levy which funds the public healthcare system. I would have no objection to something like that being put in place here as long as that money was ring-fenced for health and social care.
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Post by ProudSalopian on Mar 11, 2024 10:33:22 GMT 1
What I find interesting is whenever the NHS debate comes up, people immediately refer the USA. Just because you think the NHS is an outdated and inefficient system, it doesn't mean you automatically want the same model as the USA. I agree that the model over there is a horrific one and I wouldn't want us to go down that route but there are so many options. It's particularly ironic that our health system is criticised by people who will point to the likes of France, Germany, Australia with their supposedly much better service, but people don't want to see the insurance based systems they have over there.
Unfortunately I don't see any change for the foreseeable future, probably not even in my lifetime. The NHS has become like a sacred cow and embarrassingly so during Covid, it would be political suicide to suggest it needs modernising/revamping/overhauling and unfortunately most MP's know this so therefore the parties aren't going to do anything other than keep throwing money at it and hope it just keeps surviving somehow. The other thing which I find funny (not sure if that's the correct term) is for a few years there was a concern about the NHS, people changed their habits, changed the way they lived lives, all in the names of 'Protecting the NHS', if you didn't do this then you are selfish. But now we are back to normal and that's all forgotten about, there's lots of factors as to why the NHS is creaking but a big one is people's lifestyles mean that they will need the NHS more.
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Post by servernaside on Mar 11, 2024 12:26:57 GMT 1
As far as I can tell, Australia has a good health service system. More or less the same demographics as most other developed countries. Basic and life-threatening healthcare is provided free of charge, everything else is covered by health insurance.
It cuts out waste, it cuts out bureaucracy and it cuts out political interference.
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Post by The Shropshire Tenor on Mar 11, 2024 20:36:34 GMT 1
I may have missed it not having read every thread, but where is prevention in this debate?
The health of the public in this country isn’t good with too many overweight and obese people contributing to the epidemic of diabetes and prematurely suffering joint and heart problems.
Then there are respiratory illnesses caused by air pollution and poor and/or overcrowded living conditions.
These conditions could be moderated by government if they had the courage to ignore the jibes about the nanny state and face down the powerful processed and fast food lobbies and persuade the vociferous motoring lobby to recognise the idiocy of the majority of car journeys being less than 2 miles. It’s disturbing to read that the government tried to suppress a report showing that LTNs are popular and significantly reduce air pollution.
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Post by Feedo Gnasher on Mar 11, 2024 21:08:34 GMT 1
I may have missed it not having read every thread, but where is prevention in this debate? The health of the public in this country isn’t good with too many overweight and obese people contributing to the epidemic of diabetes and prematurely suffering joint and heart problems. Then there are respiratory illnesses caused by air pollution and poor and/or overcrowded living conditions. These conditions could be moderated by government if they had the courage to ignore the jibes about the nanny state and face down the powerful processed and fast food lobbies and persuade the vociferous motoring lobby to recognise the idiocy of the majority of car journeys being less than 2 miles. It’s disturbing to read that the government tried to suppress a report showing that LTNs are popular and significantly reduce air pollution. Spot on, sadly many people need their hand holding and need mandating what to do. The sort of preventative services that local authorities provide are always the first thing to be cut when they’re looking for savings as they’re not mandatory. You see something relatively simple, like the Labour Party wanting to mandate tooth brushing in school and it gets roundly mocked, but good habits have to start somewhere and too many people are completely incapable of doing so themselves.
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Post by venceremos on Mar 12, 2024 1:37:53 GMT 1
It's utter nonsense to dismiss the NHS model as being outdated and unfit for purpose and frankly little short of wicked to propose that we abandon a model that's generally worked very well for over 70 years and replace it with an untested system of two (or more) tier healthcare.
There's an awful lot that can be done to improve the NHS before replacing it with an inherently discriminatory and untested system.
1. As The Shropshire Tenor points out, better health prevention is an obvious way to manage the existing budget far more efficiently. Let's ignore the special interest bleating of, for example, the food industry and discourage excessive consumption of sugar and ultra-processed foods through education and, where it will help, advertising bans and taxation. It's drastically reduced tobacco consumption and can work elsewhere. If people want to bleat about a nanny state, let them. This is much more important. 2. Staff shortages need to be made up asap. We can train more doctors and nurses (and reduce or abandon tuition fees while they qualify to encourage greater take up) but we should also recruit from abroad as needed - and to hell with the immigration whingers.
3. Are there too many management layers in the NHS? I don't know and I don't trust our MPs or expect the general public to know either. Let's have a fundamental and apolitical review of the managerial structure and cut out anything that can be cut out without causing harm.
4. Possibly the biggest problem of all - we need a National Care Service to run in parallel with the NHS. The endless debate on the NHS rarely focuses on the excessive demands being put on it by our wholly inadequate care provision. No political party wants to go near the problem, because it's far bigger than a 5 year term of office can address. So the problem is never addressed and simply worsens.
Anecdotal evidence isn't everything but it can help to illustrate a problem. My dad's now in his 9th week in hospital. He had a fall at home. He wasn't injured but he couldn't get himself up and mum couldn't lift him so an ambulance came. Dad went to A&E and was pronounced medically optimised for discharge, but was given the option to stay in hospital for physio to improve his serious balance and mobility problems. He decided to stay in hospital because he didn't want to put the stress on mum, who had her own serious medical issues, by going home.
He spent time in two wards before being transferred to a sister hospital in another town, where he remains. In 8+ weeks, he's received almost no physio treatment and has either been bedbound or sitting in a chair next to his bed. Now he can't walk at all, has become institutionalised and mentally confused and is generally in a far worse state than when he entered the hospital.
He's in what's called a step down ward. There are 5 other patients there (including a couple of working age guys), all medically ok but not yet fit to go home. They need intermediate care, with personalised physio, not hospital treatment. The problem is there are very few intermediate care beds available, so dad and his fellow patients are left blocking hospital beds that others could use. To make matters worse, if an ambulance takes you to a hospital out of your home area (as happened to dad, because the paramedics know where the A&E blockages are worst and try to avoid them), it takes even longer to find intermediate care because you're out of area and become a lesser priority for your home area.
I'm sure some of you have experienced similar scenarios. If you have, you'll know it's as frustrating as it is exhausting - and ultimately heartbreaking as you watch your loved one declining. If you haven't, chances are you will eventually - or it'll be you going through it yourself.
I don't blame the NHS for this. It's not the fault of the NHS that no government has ever seriously attempted to address the increasing problem of properly funded care provision. And I bet it won't even be discussed when the election campaign begins. We get what we deserve.
Please don't suggest that an insurance based system is an answer to that, because I simply don't believe it can be. There was an attempt to explore insurance funding for care services a few years ago and it was abandoned because no insurers wanted to go near the problem. And, from a private sector perspective, who could blame them? They have to make money and they identified very quickly that it wouldn't be possible. Try asking BUPA to cover you for this if you don't believe me.
The creation of the NHS was one of the great achievements of British politics in the modern era and of fundamental importance in moving us towards a fairer and more just society. We shouldn't throw it away because of some cheap talk about how it's "not fit for purpose" that's inevitably part of a wider agenda to throw us all to the tender mercies of market forces, as if the private sector could ever provide an adequate answer to questions of public health and social justice.
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Post by kenwood on Mar 12, 2024 17:45:39 GMT 1
Excellent post Venceremos , the best I’ve read on here for a long time 👍
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Post by servernaside on Mar 12, 2024 17:58:58 GMT 1
Venceremos's post correctly addresses some of the deficiencies in the NHS, but of course fails to offer any solutions.
Some vague ideas about 'health protection', remedying staff shortages, the plethora of management layers and something called a 'care service' have, I'm sure been considered many times, but for whatever reason, not been put in place.
Tinkering around the edges of these issues isn't going to solve any of the fundamental structural problems. I'm afraid that while many in this country continue to believe that the NHS is the best invention ever, there is no real hope. Let's just continue to chuck ever-increasing sums of cash into that open mouth until it eats up the nation's entire GDP.
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The NHS
Mar 12, 2024 19:06:58 GMT 1
via mobile
Post by armchairfan on Mar 12, 2024 19:06:58 GMT 1
Just a few further thoughts: regrettably, this reminds me of the old joke about the man asking for directions from a local, and comes the reply - "well I wouldn't start from here...."
Like most on here, I am not daft enough to announce a solution or any plan - cunning or otherwise - partly due to the fact that there is disagreement about the fundamentals: some believe that our politicians, either of "Left" or "Right" are capable of reaching a palatable solution, and others, me included, find it impossible to accept that at all;
I have to say that, although it smacks of "kicking the can down the road", I am inclined to support the suggestion of a Royal Commission.....
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The NHS
Mar 12, 2024 19:28:21 GMT 1
Post by servernaside on Mar 12, 2024 19:28:21 GMT 1
Just a few further thoughts: regrettably, this reminds me of the old joke about the man asking for directions from a local, and comes the reply - "well I wouldn't start from here...." Like most on here, I am not daft enough to announce a solution or any plan - cunning or otherwise - partly due to the fact that there is disagreement about the fundamentals: some believe that our politicians, either of "Left" or "Right" are capable of reaching a palatable solution, and others, me included, find it impossible to accept that at all; I have to say that, although it smacks of "kicking the can down the road", I am inclined to support the suggestion of a Royal Commission..... Are you having a laugh? Harold Wilson once said that they 'take minutes and last years. Sir Alan Herbert MP once said that appointing a Royal Commission is like a dog burying a bone - except that a dog does eventually return to the bone. I'm sure you will agree that the last two Royal Commissions - Long Term Care of the Elderly 1997 and Reform of the House of Lords 1999, both went stunningly well. Neither reports were of course adopted.
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The NHS
Mar 12, 2024 20:58:28 GMT 1
via mobile
Post by armchairfan on Mar 12, 2024 20:58:28 GMT 1
I don't disagree, in essence, but as I intimated, in order to decide upon the direction of travel, we need to establish a consensus as to where we stand NOW, to begin with.... Tough times ahead for the NHS.....nothing new with that!
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The NHS
Mar 12, 2024 23:15:50 GMT 1
Post by venceremos on Mar 12, 2024 23:15:50 GMT 1
Venceremos's post correctly addresses some of the deficiencies in the NHS, but of course fails to offer any solutions. Some vague ideas about 'health protection', remedying staff shortages, the plethora of management layers and something called a 'care service' have, I'm sure been considered many times, but for whatever reason, not been put in place. Tinkering around the edges of these issues isn't going to solve any of the fundamental structural problems. I'm afraid that while many in this country continue to believe that the NHS is the best invention ever, there is no real hope. Let's just continue to chuck ever-increasing sums of cash into that open mouth until it eats up the nation's entire GDP. And your solution is .........? Let me guess - something vague and woolly about insurance? Memo - it's not my job, or yours, to offer solutions. Why? Because some of us are at least smart enough to know we don't know enough about it. What we can do is make observations as to what we think might improve the position. Which is what I did. Health protection? Once again basic comprehension seems to have eluded you. RTFQ, as our teachers used to say, perhaps without the F. Had to chuckle at the idea of a national care service being "tinkering around the edges" though. Show how you haven't a clue what you're talking about without saying you haven't a clue what you're talking about. Par for the course with you, amigo.
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The NHS
Mar 13, 2024 14:18:25 GMT 1
Post by servernaside on Mar 13, 2024 14:18:25 GMT 1
Venceremos's post correctly addresses some of the deficiencies in the NHS, but of course fails to offer any solutions. Some vague ideas about 'health protection', remedying staff shortages, the plethora of management layers and something called a 'care service' have, I'm sure been considered many times, but for whatever reason, not been put in place. Tinkering around the edges of these issues isn't going to solve any of the fundamental structural problems. I'm afraid that while many in this country continue to believe that the NHS is the best invention ever, there is no real hope. Let's just continue to chuck ever-increasing sums of cash into that open mouth until it eats up the nation's entire GDP. And your solution is .........? Let me guess - something vague and woolly about insurance? Memo - it's not my job, or yours, to offer solutions. Why? Because some of us are at least smart enough to know we don't know enough about it. What we can do is make observations as to what we think might improve the position. Which is what I did. Health protection? Once again basic comprehension seems to have eluded you. RTFQ, as our teachers used to say, perhaps without the F. Had to chuckle at the idea of a national care service being "tinkering around the edges" though. Show how you haven't a clue what you're talking about without saying you haven't a clue what you're talking about. Par for the course with you, amigo. If you had taken the time to look at other health systems in other countries, or even visited some of them, you would perhaps have appreciated that a hybrid form of part state funded and part insurance based health care offers a very good solution. With regard to health protection, despite all the literature and education over the past few decades, some people continue to smoke, over eat, over drink and take no exercise. If people are this dull then there is no hope. I just don't see why the rest of us should pay for their stupidity. The great thing about socialism and socialised medicine in particular, is that it inevitably reduces everyone to the lowest possible denominator.
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The NHS
Mar 13, 2024 20:55:53 GMT 1
Post by neilsalop on Mar 13, 2024 20:55:53 GMT 1
And your solution is .........? Let me guess - something vague and woolly about insurance? Memo - it's not my job, or yours, to offer solutions. Why? Because some of us are at least smart enough to know we don't know enough about it. What we can do is make observations as to what we think might improve the position. Which is what I did. Health protection? Once again basic comprehension seems to have eluded you. RTFQ, as our teachers used to say, perhaps without the F. Had to chuckle at the idea of a national care service being "tinkering around the edges" though. Show how you haven't a clue what you're talking about without saying you haven't a clue what you're talking about. Par for the course with you, amigo. The great thing about socialism and socialised medicine in particular, is that it inevitably reduces everyone to the lowest possible denominator. Speak for yourself.
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Post by neilsalop on Mar 15, 2024 7:35:41 GMT 1
1. Define 'non-critical' roles.
2. A report to the trust's board noted on Thursday it had a deficit of £91.7m against its planned deficit of £45.3m. WTF.
1. We have got a recruitment challenge at the PRH, we seem to be losing a lot of people to other organisations.
2. To get the centre open, the hospital has agreed to bring in staff from an outsourcing company.
Great, so all those people that they have lost to 'other organisations' will still be staffing the unit, but the outsourcing company/agency will take their cut first, which in turn will lead to further pressures on the f***ing deficit. You really have to wonder who the hell is supposed to running this bloody Trust.
I don't lay any of the blame at the feet of the clinical staff for this. Most of them are doing their very best in increasingly difficult circumstances, working long hours for in many cases mediocre pay for what the job entails. This is purely down to p**s poor management at the highest levels, both at the Trust and in Whitehall.
I agree that throwing money at the NHS is not the way forward and that it needs a serious review. One day in the future there will undoubtedly be a requirement for some sort of insurance system to be put in place if we want to keep the NHS, but that insurance system needs to be a public one. By all means use the expertise of the insurance sector to get it up and running, but that's where their involvement needs to end. No exemptions for 'pre-existing conditions', no excesses, no co-pays or deductibles like in the US and most importantly no huge profits going out of the country, any money left over at the end of every financial year needs to be used to bring down premiums or re-invest in making the system better.
One of the biggest problems with NHS over the years has been procurement. The biggest single buyer in the country should be paying fair prices for EVERYTHING, but that isn't happening, because there isn't a single entity going to the suppliers and demanding those fair prices, every Trust is buying in from a position of weakness. That's what has led to suppliers being able to charge whatever they like for the most basic of commodities. Some of the Trusts have got together to demand better prices, but until they all start working together the suppliers are continue fleecing them and us.
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The NHS
Mar 15, 2024 10:55:03 GMT 1
Post by staffordshrew on Mar 15, 2024 10:55:03 GMT 1
I would have to have it explained to me why we need Trusts? Phone for an ambulance and, depending on severity of the case and how busy hospitals are, you could be taken from, say, High Ercall, to Shrewsbury or Telford, Stoke, New Cross, Birmingham. Do the different Trusts have to sort out money transfers to pay for that care, I don't know? But a regional or national administration strikes me as a better idea, avoiding duplication?
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Post by ssshrew on Mar 15, 2024 11:02:53 GMT 1
I can’t see the need for trusts either. They are like the ones who purport to run schools. Top heavy with a lot of non experts who are just there for the money.
There was nothing wrong with the old systems. And don’t start me on the shambles that is our railway system.
The old systems weren’t perfect but at least there was only one body to deal with.
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Post by The Shropshire Tenor on Mar 15, 2024 12:41:01 GMT 1
Neil mentions procurement in the NHS, I was a purchasing manager for over 30 years so know a little about the job. Sales staff are highly trained and motivated, buyers have to be a match for them. I did several years of night school to earn my professional qualifications.
Imagine my surprise when my daughter told me that a good friend from university had been fast tracked to head an NHS procurement office.
His qualification? A masters in 19th century Irish literature.
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Post by servernaside on Mar 15, 2024 13:52:21 GMT 1
Neil mentions procurement in the NHS, I was a purchasing manager for over 30 years so know a little about the job. Sales staff are highly trained and motivated, buyers have to be a match for them. I did several years of night school to earn my professional qualifications. Imagine my surprise when my daughter told me that a good friend from university had been fast tracked to head an NHS procurement office. His qualification? A masters in 19th century Irish literature. Marvellous! With a skill set like that, what could possibly go wrong?
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The NHS
Mar 15, 2024 14:40:06 GMT 1
via mobile
Post by ssshrew on Mar 15, 2024 14:40:06 GMT 1
I rest my case about trusts!
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Post by kenwood on Mar 15, 2024 14:41:54 GMT 1
Neil mentions procurement in the NHS, I was a purchasing manager for over 30 years so know a little about the job. Sales staff are highly trained and motivated, buyers have to be a match for them. I did several years of night school to earn my professional qualifications. Imagine my surprise when my daughter told me that a good friend from university had been fast tracked to head an NHS procurement office. His qualification? A masters in 19th century Irish literature. Marvellous! With a skill set like that, what could possibly go wrong? Brilliant , sometimes you have to wonder don’t you. Mind you ST didn’t tell you his qualifications after attending night school for many years was in plastering .😉👍
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Post by Red Rose In Exile on Mar 15, 2024 14:44:35 GMT 1
Marvellous! With a skill set like that, what could possibly go wrong? Brilliant , sometimes you have to wonder don’t you. Mind you ST didn’t tell you his qualifications after attending night school for many years was in plastering .😉👍 Is that limbs or walls??!!
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