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We had excellent Public Health test and trace departments who had a wealth of experience of tracing people for sexual health purposes. But we still chose to giv

by DanBC 6y ago

We had excellent Public Health test and trace departments who had a wealth of experience of tracing people for sexual health purposes. But we still chose to give the contract to Dido Harding despite her poor record at NHS Improvement. And I saw what happened to NHS Logistics, which was one bit of the NHS that wasn't losing money. It was running well. It was privatised to DHL in 2006 for purely ideological reasons, and then for several years was terrible. Ten years later, after Lord Carter's report into efficiency and productivity, we set up a new org called NHS Supply Chain and in effect re-nationalised it by giving the responsibility to a company which is owned by the Secretary of State for the Department for Health and Social Care. I don't think anyone has really learned any lessons from that.

ksec 6y ago
From a high level overview and global perspective, what the OP is saying, or meant, is that comparatively speaking UK is much better than possibly 80% of developed countries. Not to say NHS is without flaws, far from it. But if you step outside and look around the world many are surprised how awful public health services and logistics can be. So to put it another way, It is not that NHS is good, it is just the others are worse. Although this conclusion or opinion also makes me rather sad.
- Wintamute 6y ago
  What you're missing is that amongst a certain class of Brit, and across much of the West, relentless and savage cultural self-criticism has become the norm, and a currency used for in-group signalling. Even when people in the UK should be celebrating, as literally the first country in the world to develop an approved C19 vaccine in record breaking time, and enjoy the privilege of a free health system that can roll it out within _weeks_ they still find a way to twist it. Asking them to truly recognise the fact that there indeed exists big differences between the UK and much of the world in this respect will fall on deaf ears - it doesn't serve their purpose - which to be clear, isn't truth-telling or (heaven forbid expressing pride in their national achievements) it's a habit of personal advancement at the expense of others and dissolving their own culture in an acid bath of manifold criticism. It's only where this sort of criticism is expressed in forums with international readers, many in far less fortunate positions, does it begin to reveal itself for the pathology that it is.
  - MaxBarraclough 6y ago
    > it's a habit of personal advancement at the expense of others How does this relate to your point about a culture of self-criticism?
    - Wintamute 6y ago
      My point was related to cultural self-criticism, i.e. criticising your own culture, not a culture of (personal) self-criticism.
  - jack_pp 6y ago
    I'm not from the UK but assuming the grandparent is right, you're saying they should be thankful that their country isn't as corrupt as other countries even though there's blatant corruption in something as important as the COVID response? That's like beating your children but comforting them that they atleast have food on the table and clothes on their back.
    - jl6 6y ago
      A better analogy would be living in a nice comfortable house, which is much better than nearly all other houses - but then someone spots a problem with the chimney and starts comparing it to other houses’ chimneys, some of which have better chimneys, some of which have better chimneys but a worse overall house, and some of which are fantasy chimneys that could theoretically exist if only we all spent a bit more time thinking about chimneys. And in amongst all this chimney woe, the fundamental qualities of the house and the fundamental privilege of having such a house go forgotten.
      - tonyhb 6y ago
        Not quite. A substantial number of people in the UK live in poverty - between 20 and 25% [0]. This has been made worse by terrible political decisions, such as Brexit [0]. Specifically, austerity and political decisions (not limited to corruption) is linked to 130,000 preventable deaths [1]. Those same "budget cuts" for austerity exist while money is sent to "consultants" to "help fix things". Not everyone in the UK has it well. The government, quite frankly, is fairly shit. And corrupt. [0] - https://www.ifs.org.uk/publications/14901 https://www.ifs.org.uk/publications/14901 [1] - https://www.theguardian.com/politics/2019/jun/01/perfect-storm-austerity-behind-130000-deaths-uk-ippr-report https://www.theguardian.com/politics/2019/jun/01/perfect-sto...
- DanBC 6y ago
  Yep, sure. But we said that about pandemic preparedness and yet here were are with a minimum of 60,000 excess deaths.
thu2111 6y ago
That story can easily be told in reverse. NHS Logistics didn't run well. As is consistently true of government run organisations it was run so badly that most of the NHS didn't even try to use its services. At the time of the privatisation the NHS sourced around half a million products but only acquired 50,000 of them via NHS Logistics. The entire purpose of privatising it was to try and make it work better and thus to encourage the NHS to buy more centrally to get bulk discounts, something that wasn't going to happen for as long as doing so required them to work with a small, sclerotic socialised bureaucracy. Why would anyone think that an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment, be better at delivering things than DHL, a world famous delivery and logistics company that the NHS frequently chose to use anyway in preference to its own operation? That's ideology. How much did NHS Logistics workers care about the health of the citizens who paid their salaries? Not at all: even though many of them were going to keep their jobs anyway they reacted to privatisation by going on strike and picketing trucks to stop them delivering supplies to hospitals. That's ideology. Fortunately it didn't kill anyone, but only because hospitals were already mostly bypassing the striking workers already due to aforementioned poor performance. The NHS had its limits thrown into sharp focus this year. Mass testing is a bad idea, but putting that to one side for a moment, Germany and indeed most other places were able to ramp up test volumes far faster than the UK did, because Germany used private labs from the start when the NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible. That's ideology. Finally, the supply chain hasn't been effectively renationalised. The contract changed from DHL to Unipart: https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logistics-contract-is-unipart-capable/ https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logis... Supply Chain Coordination Ltd is what the name suggests: a relatively small coordinating body that manages contracts for various services, including contracts for logistics provisioning. The brutal reality about the NHS is that not a single country in the world has copied this model. If it was good we'd see other countries adopt it but they don't. They don't adopt it because it's not good: this model is a relic of a time when the British public had just won a world war and as such had been exposed to years of war propaganda that made the government look artificially competent. In countries where that didn't happen the idea you'd want a single, centralised government agency to run every aspect of something as vital as healthcare was seen as insane: after all, if you go down that route why not have the government supply all food too? All entertainment? Why not run a fully USSR-style economy? Well because we know it doesn't work, that's why. There's nothing magical about the NHS that renders all those experiences irrelevant.

by DanBC 6y ago

ksec 6y ago

From a high level overview and global perspective, what the OP is saying, or meant, is that comparatively speaking UK is much better than possibly 80% of developed countries. Not to say NHS is without flaws, far from it. But if you step outside and look around the world many are surprised how awful public health services and logistics can be. So to put it another way, It is not that NHS is good, it is just the others are worse. Although this conclusion or opinion also makes me rather sad.

Wintamute 6y ago
What you're missing is that amongst a certain class of Brit, and across much of the West, relentless and savage cultural self-criticism has become the norm, and a currency used for in-group signalling. Even when people in the UK should be celebrating, as literally the first country in the world to develop an approved C19 vaccine in record breaking time, and enjoy the privilege of a free health system that can roll it out within _weeks_ they still find a way to twist it. Asking them to truly recognise the fact that there indeed exists big differences between the UK and much of the world in this respect will fall on deaf ears - it doesn't serve their purpose - which to be clear, isn't truth-telling or (heaven forbid expressing pride in their national achievements) it's a habit of personal advancement at the expense of others and dissolving their own culture in an acid bath of manifold criticism. It's only where this sort of criticism is expressed in forums with international readers, many in far less fortunate positions, does it begin to reveal itself for the pathology that it is.
- MaxBarraclough 6y ago
  > it's a habit of personal advancement at the expense of others How does this relate to your point about a culture of self-criticism?
  - Wintamute 6y ago
    My point was related to cultural self-criticism, i.e. criticising your own culture, not a culture of (personal) self-criticism.
- jack_pp 6y ago
  I'm not from the UK but assuming the grandparent is right, you're saying they should be thankful that their country isn't as corrupt as other countries even though there's blatant corruption in something as important as the COVID response? That's like beating your children but comforting them that they atleast have food on the table and clothes on their back.
  - jl6 6y ago
    A better analogy would be living in a nice comfortable house, which is much better than nearly all other houses - but then someone spots a problem with the chimney and starts comparing it to other houses’ chimneys, some of which have better chimneys, some of which have better chimneys but a worse overall house, and some of which are fantasy chimneys that could theoretically exist if only we all spent a bit more time thinking about chimneys. And in amongst all this chimney woe, the fundamental qualities of the house and the fundamental privilege of having such a house go forgotten.
    - tonyhb 6y ago
      Not quite. A substantial number of people in the UK live in poverty - between 20 and 25% [0]. This has been made worse by terrible political decisions, such as Brexit [0]. Specifically, austerity and political decisions (not limited to corruption) is linked to 130,000 preventable deaths [1]. Those same "budget cuts" for austerity exist while money is sent to "consultants" to "help fix things". Not everyone in the UK has it well. The government, quite frankly, is fairly shit. And corrupt. [0] - https://www.ifs.org.uk/publications/14901 https://www.ifs.org.uk/publications/14901 [1] - https://www.theguardian.com/politics/2019/jun/01/perfect-storm-austerity-behind-130000-deaths-uk-ippr-report https://www.theguardian.com/politics/2019/jun/01/perfect-sto...
DanBC 6y ago
Yep, sure. But we said that about pandemic preparedness and yet here were are with a minimum of 60,000 excess deaths.

thu2111 6y ago

That story can easily be told in reverse. NHS Logistics didn't run well. As is consistently true of government run organisations it was run so badly that most of the NHS didn't even try to use its services. At the time of the privatisation the NHS sourced around half a million products but only acquired 50,000 of them via NHS Logistics. The entire purpose of privatising it was to try and make it work better and thus to encourage the NHS to buy more centrally to get bulk discounts, something that wasn't going to happen for as long as doing so required them to work with a small, sclerotic socialised bureaucracy. Why would anyone think that an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment, be better at delivering things than DHL, a world famous delivery and logistics company that the NHS frequently chose to use anyway in preference to its own operation? That's ideology. How much did NHS Logistics workers care about the health of the citizens who paid their salaries? Not at all: even though many of them were going to keep their jobs anyway they reacted to privatisation by going on strike and picketing trucks to stop them delivering supplies to hospitals. That's ideology. Fortunately it didn't kill anyone, but only because hospitals were already mostly bypassing the striking workers already due to aforementioned poor performance. The NHS had its limits thrown into sharp focus this year. Mass testing is a bad idea, but putting that to one side for a moment, Germany and indeed most other places were able to ramp up test volumes far faster than the UK did, because Germany used private labs from the start when the NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible. That's ideology. Finally, the supply chain hasn't been effectively renationalised. The contract changed from DHL to Unipart: https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logistics-contract-is-unipart-capable/ https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logis... Supply Chain Coordination Ltd is what the name suggests: a relatively small coordinating body that manages contracts for various services, including contracts for logistics provisioning. The brutal reality about the NHS is that not a single country in the world has copied this model. If it was good we'd see other countries adopt it but they don't. They don't adopt it because it's not good: this model is a relic of a time when the British public had just won a world war and as such had been exposed to years of war propaganda that made the government look artificially competent. In countries where that didn't happen the idea you'd want a single, centralised government agency to run every aspect of something as vital as healthcare was seen as insane: after all, if you go down that route why not have the government supply all food too? All entertainment? Why not run a fully USSR-style economy? Well because we know it doesn't work, that's why. There's nothing magical about the NHS that renders all those experiences irrelevant.