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ThomasPaine posted:I have liked most of the anarchists I have met but I dunno I kind of would like some large scale manufacturing and research sector and that doesn't seem like it could work. I don't think we'd have made it to the moon if we lived in little autonomous communes The factory/mill/refinery/whatever would be run as a workers syndicate, which its self is probably a member of a larger syndicate or group looking after the industry on a wider scale. There's no reason large scale industry isn't possible.
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Apr 5, 2016 16:09
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Blacknose posted:The factory/mill/refinery/whatever would be run as a workers syndicate, which its self is probably a member of a larger syndicate or group looking after the industry on a wider scale. There's no reason large scale industry isn't possible. What about the NHS?
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Apr 5, 2016 16:11
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I don't loving know mate, I'm just in it for the shouting. (The same applies as to large scale industry)
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Apr 5, 2016 16:12
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Sounds like a plan. Full Anarchism Now.
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Apr 5, 2016 16:14
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The NHS might actually even benefit from removing a lot of the middle management fat and flattening its hierarchy. Healthcare's a collaborative profession anyway. EDIT: Middle management seems uniformly incompetent wherever I've encountered it, in fact. In a syndicate or whatever you want to call it, the workforce might actually be able to ask for and get the resources it needs to do its job effectively, without a bunch of obstructive bureaucrats who've never done that job making excuses and standing in the way. TomViolence fucked around with this message at 16:22 on Apr 5, 2016 |
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Apr 5, 2016 16:17
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TomViolence posted:The NHS might actually even benefit from removing a lot of the middle management fat and flattening its hierarchy. Healthcare's a collaborative profession anyway. Who are you thinking of here when you refer to "middle management fat"? Maybe I'm misunderstanding who you're aiming this at, but there's a ton of stuff that goes on in the NHS that would be a total waste of a doctor's or nurse's time. Take any of the examples here and consider if it makes sense for a doctor to be doing any of them instead of treating patients.
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Apr 5, 2016 16:46
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TomViolence posted:The NHS might actually even benefit from removing a lot of the middle management fat and flattening its hierarchy. Healthcare's a collaborative profession anyway. yeah what does the procurement department do anyway?
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Apr 5, 2016 16:49
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TomViolence posted:The NHS might actually even benefit from removing a lot of the middle management fat and flattening its hierarchy. Healthcare's a collaborative profession anyway. Isn't that the justification for a lot of the cuts though? Get rid of the pencil pushers they don't do anything anyway, then six months later realise that people who are trained to provide medical care or teach children are spending a good portion of their working day filling in forms, chasing notes and ordering paperclips or whatever. Then the whole department gets a virulent disease contracted from a dirty telephone and the planet is doomed. hookerbot 5000 fucked around with this message at 17:04 on Apr 5, 2016 |
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Apr 5, 2016 17:01
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But weren't posts for a lot of pencil pushers created by the 'internal market' stuff?
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Apr 5, 2016 17:02
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I can't remember who it was, maybe Krugman, but they pointed out that middle-management was invented to manage the fact that trampling workers' rights leads to high-employee turnover (to keep them precariously employed), and so therefore middle-managers were needed to get the newbies in line to keep the wheels greased. Effectively, middle management is a tumour of capitalism.
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Apr 5, 2016 17:03
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Tesseraction posted:I can't remember who it was, maybe Krugman, but they pointed out that middle-management was invented to manage the fact that trampling workers' rights leads to high-employee turnover (to keep them precariously employed), and so therefore middle-managers were needed to get the newbies in line to keep the wheels greased. Eh, I don't really buy it. It's more an artifact of scale. You can look at the early modern period pre-modern capitalism when management was much smaller and, uh, a lot of the time it didn't go well.
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Apr 5, 2016 17:12
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I don't understand why anyone who's been to a hospital running on a single receptionist thinks getting rid of penpushers is a workable idea. Medical staff should have the seniority to say "gently caress you we need these things, get them", sure. But you still need someone to actually do the busywork.
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Apr 5, 2016 17:15
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I might have this wrong, but under syndicalism workers' interests would be represented democratically in a sort of expanded trade union system, and so while there might still be managers they would be more like shop stewards or whatever. Middle management's role would be overtaken by these representatives, presumably in some sort of rotation, who would hopefully be better able to mediate the concerns of their respective workforces. As things stand, a lot of middle management roles in many industries, not just healthcare, are staffed by people who have no experience or knowledge of the jobs performed by the employees under them and their consequent needs in terms of resources or working conditions. Of course in this wonderful imagined utopia of harmonious labour relations there will probably be other factors that I haven't thought of that would make such things more workable than they currently are. Management and bureaucracy may be a necessary part of a functioning industry and I might just have put things badly, but my point was more that the ethos and implementation is pretty poo poo and could stand to be changed. EDIT: Also, I don't think admin staff who spend their days filing or behind reception desks really count as middle management. Those people are part of the frontline workforce as far as I'm concerned and their pay also tends to reflect that. TomViolence fucked around with this message at 17:22 on Apr 5, 2016 |
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Apr 5, 2016 17:20
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TomViolence posted:As things stand, a lot of middle management roles in many industries, not just healthcare, are staffed by people who have no experience or knowledge of the jobs performed by the employees under them and their consequent needs in terms of resources or working conditions. Here's a quick search on NHS Jobs for 'Managers' on at least £40k. Feel free to have a look at them - I'd be interested in knowing which ones you think are unnecessary.
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Apr 5, 2016 17:25
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What's the rationale behind use of trusts vs central planning? A national health service, with it's huge procurement and infrastructure demands, should surely operate as a monolithic entity. The breakdown into trusts has advantages I can see in the filtering of information that is not locally relevant, but I still don't see why giving them the money is a good idea.
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Apr 5, 2016 17:45
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the rationale was they needed a framework to facilitate competition (which is always good)
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Apr 5, 2016 17:56
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The thing of what makes makes an manager in the NHS is really fuzzy anyway. By some counts I'm a manager because I make over £30K and am the lead for a system. There are a lot of people who think the NHS is short on mid/mid-high level admin staff to manage, provide analysis, etc. I agree with them, but don't have the experience of working in any of the national bodies to back it up personally. A truly national system could have a much more monolitch structure, but we don't have that. Plus local variation is key. Issues in South Devon aren't the same as in Central London, etc, etc. Though as above, I clearly have a stake in this and I'm record as an "The NHS is being screwed and killed off" person.
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Apr 5, 2016 18:01
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The idea of 'trimming the fat' from the NHS has never made much sense to me, really. I don't doubt that there are efficiency and cost savings that could be made here and there, but it's worth remembering that the NHS is amongst the cheapest healthcare in the developed world systems in terms of per capita spending (really the only measure that makes sense) in the developed world, which is remarkable when you consider the size of it, and we're not seeing any statistical difference in terms of mortality rates compared with any of its 'competitors'. Spending billions on management consultants to 'streamline' things is gonna lose far more than it saves, realistically.
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Apr 5, 2016 18:07
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Tesseraction posted:I can't remember who it was, maybe Krugman, but they pointed out that middle-management was invented to manage the fact that trampling workers' rights leads to high-employee turnover (to keep them precariously employed), and so therefore middle-managers were needed to get the newbies in line to keep the wheels greased. Well, it's sort of logical in that the necessity of precarious employment creates a specific job role designed to deal with the effects of that. But the idea of just dividing labour more precisely so that you have a specialist for paperwork and a specialist for whatever the front end of your business is, isn't outlandish. It may be that with small enterprises you have to do everything yourself but you should ideally reach a point where you can create a very specific paperwork role and free up your actual service providers from having to do all that.
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Apr 5, 2016 18:14
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An anarchist NHS could still have middle managers and regional directors, but they'd be voted for or otherwise appointed by the people below them, not above them. Also medicines would be cheaper because all the capitalists would have been thrown into a lime quarry. One of the key questions of the syndicalist mode of organization is how to do this without just recreating hierarchy all over again.
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Apr 5, 2016 18:20
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I work in NHS analytics, a good third of us are employed to monitor the internal contracts between commissioners and trusts (I. E. They send us their patient records for the month and how much they'd like to be paid for them, we measure that cost and activity against the plan and if they've hosed up somewhere then the costs are challenged and penalties against the trust levee'd). To be honest this is slightly less awful than it sounds because this activity should be monitored anyway, it's just garbage the person hours that take place calculating and arguing over the penalties. If the penalties were just used in an actuary sense to stress priorities then fine but commissioners are as strapped for cash as trusts (to the extent that they had to be issued reminders that penalties are supposed to be directed back at the problems through some sort of program rather than just kept) it's an outrage.
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Apr 5, 2016 18:20
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DroneRiff posted:The thing of what makes makes an manager in the NHS is really fuzzy anyway. By some counts I'm a manager because I make over £30K and am the lead for a system. Literally everyone on my four man team except me is a manager, and none of the other three actually manages me. The title is meaningless.
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Apr 5, 2016 18:26
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It's all bullshit cut the fat that is lowering tax on income over £40k, lowering capital gains tax and lowering corporation tax and call it an efficiency saving or something
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Apr 5, 2016 18:26
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JFairfax posted:So they initiated force and theft. They broke the NAP. I knew the left anarchists were not real anarchists, but I never knew they would do something that bad. I didn't know what this NAP thing was so I looked it up and holy  it is the dumbest thing I've ever heard.I mean I already knew ancaps were loving idiots, but I think believing that any kind of unequal system can be enforced without literal force is the biggest disconnect from reality in their entire lovely philosophy (possibly tied for first place with the failure to understand that neofeudal lords making GBS threads on the untermensch is itself an act of force/violence)
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Apr 5, 2016 18:28
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NAP is fine with violence, it just says violence to defend private property is the only moral form of violence.
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Apr 5, 2016 18:34
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There is definately fat in the NHS to cut. Basically 2/3 of the shite that is used to keep doctors on a short leash could be removed with no harm. Get rid of NHS ePortfolios and e-learning and you'd save a few million. Stop trying to implement physician associates as a lovely gapfiller and just train some healthcares to bear the brunt of ECGs, blood taking and cannula insertion. End overbearingly tight IT security that just gets circumvented in fairly unsafe ways. Have a real meaningful review of all the documentation we produce and decide how much of it is actually useful. Heads of nursing appear to do nothing of value and could all be culled immediately. That said the main issue is lack of funding to clinical services.
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Apr 5, 2016 18:35
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winegums posted:End overbearingly tight IT security that just gets circumvented in fairly unsafe ways. Only if you replace it with proper face to face information security training. e/ Or add that to it, even. I'm not really sure what specifically you're referring to with "overbearingly tight security", from my perspective as a clerk there's nothing especially onerous that isn't also entirely appropriate (except for the fact that our main database uses Java, but that's a different gripe) Renaissance Robot fucked around with this message at 18:48 on Apr 5, 2016 |
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Apr 5, 2016 18:45
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Oberleutnant posted:I mention the SWP especially because there seemed to be quite a few of them at Dover on Sat but the lack of solidarity was notable. There weren't any women to rape in Dover, I bet.
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Apr 5, 2016 18:49
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Renaissance Robot posted:Only if you replace it with proper face to face information security training. Individual permission required to access each blood gas machine Clinical patient information inaccessible online as "the system cannot verify you have sufficient valid interest in this patient". The fact that I need to send a ticket request, and have a consultant sign off on, any folders I want set up on the network and for any addition or removal of people's access to these folders. End result being we just store everything on C:\, or print out ward lists and tape them to the monitor for the weekend.
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Apr 5, 2016 18:55
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Quote-Unquote posted:The idea of 'trimming the fat' from the NHS has never made much sense to me, really. I don't doubt that there are efficiency and cost savings that could be made here and there, but it's worth remembering that the NHS is amongst the cheapest healthcare in the developed world systems in terms of per capita spending (really the only measure that makes sense) in the developed world, which is remarkable when you consider the size of it, and we're not seeing any statistical difference in terms of mortality rates compared with any of its 'competitors'. Spending billions on management consultants to 'streamline' things is gonna lose far more than it saves, realistically. "Ban the drugs." Which drugs? Oh, you know, the bad ones, that undesirable people do. You can't really define them but you'll definitely know them when you see them. "Trim the fat." Which fat? Oh, you know, lazy pencil-pushers just sort of shuffling papers all day. You can't really specify them but you'll know them when you see them. It's a pattern that appears again and again. It appeals to people's gut feeling that there's some villainous element sneakily causing all the world's problems that can be cleanly excised, when obviously everything is actually a lot more complicated and requires careful examination and thinking about to solve. Ugghh, how BORING. Just like, fix it.
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Apr 5, 2016 18:55
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https://donation.labour.org.uk/w/postcards-donate Don't know what to think of this. I think I'd actually buy the posters ones if they were actual posters, but they picked the wrong Bevan quote (you know which one's the right one) and two of the four "Iconic Quotes" ones are from Corbyn, which is a teeny bit egotistical IMO. Worst of all though, making Clause IV a sort of cheery cheesy political equivalent of Keep Calm And Carry On really seems ridiculously tone-deaf.
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Apr 5, 2016 19:03
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Renaissance Robot posted:Only if you replace it with proper face to face information security training. One overly tight security mess is with Commissioning support units and personal details. Commissioners are required (as in are legally required to) to have service arrangements with outside organisations like CSUs or private data companies but because these aren't considered NHS organisations or deal directly with care situations they aren't allowed to have free access to patient information like NHS numbers, instead they must be an accredited safe haven which allows them some access to data but not all of it. However since we do deal in situations where we have to identify patients by their NHS numbers or receive data with NHS numbers in it there are a few members of staff at the CSUs which are technically employed by a different NHS organisation which means they are allowed to see NHS numbers. Some of these people sit opposite me in an open plan office. These people are responsible for building our data warehouse with pseudo NHS numbers replacing the real ones meaning we can identify patients within our system but not with any other organisation.
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Apr 5, 2016 19:03
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Oh god the CSU thing is such a total mess. The fact the number of CSUs has dropped like a stone since their creation because they're not viable businesses... At least some national things have gotten better (in my view). HSCIC (who over see a lot of the national data and systems) are insourcing things back from ATOS and BT. So the NHS actually owns these systems (like e-Referral Service vs Choose and Book) and can actually make changes. One example, when PCTs became the GP CCG groups, ATOS wanted to charge the NHS £500k to change the database heading in Choose and Book. They left it as PCT, until they moved away from ATOS
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Apr 5, 2016 19:10
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goddamnedtwisto posted:Worst of all though, making Clause IV a sort of cheery cheesy political equivalent of Keep Calm And Carry On really seems ridiculously tone-deaf.
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Apr 5, 2016 19:10
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goddamnedtwisto posted:https://donation.labour.org.uk/w/postcards-donate Corbyn is the leader of the Labour Party... 'Now, Win the Peace' seems a little more tone deaf to me. These are the cards I tried to buy earlier and had my card blocked by HSBC 
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Apr 5, 2016 19:15
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oh my loving god I just saw this on the BBC frontpage http://www.bbc.co.uk/news/uk-35969391 IDS crying about a woman his department screwed being listless and angry
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Apr 5, 2016 19:17
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ThomasPaine posted:oh my loving god I just saw this on the BBC frontpage lol he's having a loving breakdown
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Apr 5, 2016 19:23
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ThomasPaine posted:oh my loving god I just saw this on the BBC frontpage He's probably only crying because he feels he didn't gently caress her over hard enough. It's so loving disingenuous - "Oh, she wants to be better, my god people need help, I feel some notion of care" *Proceeds to vote for laws to trample the uppity paups.*
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Apr 5, 2016 19:28
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I'm going by Buffy logic here, but is it possible Iain Duncan Smith was cursed with a human soul and only now understands the misery and pain he caused? Or more literary, did a Yithian just leave? Not Operator fucked around with this message at 19:44 on Apr 5, 2016 |
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Apr 5, 2016 19:37
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I guess we know exactly what kind of reptilian he is. crocodile
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