Our Lord, J.C.

[Idaho]

I think that is a separate phenomenon with the same name.

[rory_20_uk]

I don't care who owns things - private or state - I just want them to work British Rail was not a fantastic system either.

The main issue is that unlike the companies that formed in the first place before nationalisation were geographic entities that owned everything. Splitting into different ones that own different bits is madness.

Private companies are bad as they have to make profits. Public companies are bad since they don't (and hence stagnation, lack of innovation and cronyism is often the problems) and how for example a private hospital can make money from doing an operation whereas a NHS hospital can not.

[Greyblades]

[Idaho]

Strange how Cameron the student pot head is resolutely in favour of locking up young people caught with cannabis, yet Corbyn, who has never done any drugs, is against ruining the lives of the same young people.

[Beskar]

Private companies are bad as they have to make profits. Public companies are bad since they don't (and hence stagnation, lack of innovation and cronyism is often the problems) and how for example a private hospital can make money from doing an operation whereas a NHS hospital can not.

Sorry Rory, I got to cut in here what you just said is a misnomer. The reason the NHS cannot make 'a profit' is not because the private is better, it frankly isn't, as the NHS does it for significantly cheaper, but because money for NHS is paid upfront from taxes, and is providing a service, whilst the private will charge an individual for a service at above the cost of service. The profit in this regard 'cannot make a profit' but we as members of society do get our 'profit' in terms of having good quality healthcare which is essentially 'free' at use and don't need to worry about getting slapped with £50000 bill for a couple of days in A&E after an accident like in the USA.

[Husar]

What stops one from rewarding innovation in a non-profit system? The reward for the doctor is just another expense and not a profit. Research costs are not profit. The only thing that won't happen is that the system needs to cater to investors (sometimes perhaps even the pension funds of the patients...) who have their own ROI in mind instead of what's best for the patients.

[rory_20_uk]

What stops one from rewarding innovation in a non-profit system? The reward for the doctor is just another expense and not a profit. Research costs are not profit. The only thing that won't happen is that the system needs to cater to investors (sometimes perhaps even the pension funds of the patients...) who have their own ROI in mind instead of what's best for the patients.

From experience - the ethos of the system. Everyone has nice big final salary pensions. There isn't anything to gain from thinking outside the structure and there is a risk of not getting one's statutory promotion for time served.

Who in a hospital has what is best for the patient in mind? Everyone wants to get paid and get home with as little grief as possible. Whistle blowers can have their career wrecked for decades. Reporting a mistake is an admission of guilt. Keep one's head down and take the pay.

There's no need to attract patients - they have no choice but to go to the hospital regardless of what state it is in - many areas there is no other hospital and the good ones often have no ability or desire to expand. If you go bust the central government will wave a magic wand all all the debts disappear and things continue as before.

[rory_20_uk]

Sorry Rory, I got to cut in here what you just said is a misnomer. The reason the NHS cannot make 'a profit' is not because the private is better, it frankly isn't, as the NHS does it for significantly cheaper, but because money for NHS is paid upfront from taxes, and is providing a service, whilst the private will charge an individual for a service at above the cost of service. The profit in this regard 'cannot make a profit' but we as members of society do get our 'profit' in terms of having good quality healthcare which is essentially 'free' at use and don't need to worry about getting slapped with £50000 bill for a couple of days in A&E after an accident like in the USA.

Never said the private sector is better. Private hospitals are doing many operations on NHS patients for NHS tarrifs. Is that because they suddenly have a change of heart and are doing work pro bono? That this is some clever PR ruse? No - they can make a profit on the elective surgery by doing things more efficiently than the NHS does.

How?

Depends on the hospital . But some things I have seen

NHS in an NHS hospital the entire theatre staff bieng paid until 8.30pm at night when all elective surgery finished at 5.30 - yes of course there needs to be facilities for emergency surgery - but identical numbers of staff as during the day? No one had noticed that this was happening for years. No one cared.

The theatre stopped working for several hours since they were short of a porter to get the next patient down - so about 10 people twiddle their thumbs for a few hours.

Get this level of wastage happening on a regular basis and guess what? The cost per completed operation goes up. Others who manage to employ enough porters to ensure the extremely expensive theatres are working to capacity get through more work.

[Beskar]

Never said the private sector is better. Private hospitals are doing many operations on NHS patients for NHS tarrifs. Is that because they suddenly have a change of heart and are doing work pro bono? That this is some clever PR ruse? No - they can make a profit on the elective surgery by doing things more efficiently than the NHS does.

This is to cover the demand needed to run private surgeries, so they take work at cut-price because they can get something for it and as you said yourself, the solve private sector thumb twiddling by having people to operate on during a lull. There is even the reverse happening where BUPA rents out NHS surgeries at higher than NHS costs to get their clients seen during said lull periods.

The same even happens in Nursing Homes, private homes charge twice the rate for private funded, but they take on council funded clients to make up numbers because having lower paid in beds is better than having 5 empty beds. It is the same line of thought.

It is economics. They only accept the work because they have to and it isn't simply for massive profits.

[rory_20_uk]

They have to??!? An operating theatre is a room with some equipment in it. The main costs are the staff. If they have no work they'll not have the staff. NHS contracts going to private hospitals is relatively recent. The private hospitals were profitable before this ever started.

The private hospitals are good at finding ways of making more profit such as taking contracts for NHS work as opposed to doing nothing and idly sit around which is what the NHS is good at doing since no one can be bothered to try and do anything better. But if there was no money in it they'd just not have operations being performed.

The money nursing homes get from the council is decreasing in real terms for years. Many would go to the wall without fleecing private residents - and only by doing so do they manage to keep going. Their business model assumed higher levels of funding and that is why some are increasingly cutting corners or folding altogether.

[Philippus Flavius Homovallumus]

I think the NHS suffers from a lack of goodwill. Look at Rory - he's the kind of guy they have working for them, and he's so disillusioned.

I reckon Corbyn can't fix that.