Private Speech posted:

Yeah and it wouldn't even change anything about the trade barriers, which is the funniest part.

Guavanaut posted:

There was a period of a few weeks where I kept getting poo poo like this as adverts on facebook

and I'm not quite sure who it's for.

quote:

Until 1918, he was an admirer of the British Empire and only came to advocate full independence after the Amritsar Massacre of 1919.

Jose posted:

The left wing party who are not the government have clearly rigged the election so they win

Lol cool

https://twitter.com/adamhamdy/status/1360876177339129856?s=19

happyhippy posted:

It's for intentional bad faith argumentors, those that are Alf Garnett dialed to 11.
I googled those examples and most have a 'but we caused or made it worse' end bit that is conveniently ignored.


Where the British Army fired upon protestors killing 400, injuring 1200.
BUT YOU SEE GANDI LUVVED US AHA!

knox_harrington posted:

Jose posted:

cool of the independent to publish this


https://twitter.com/drbobgill/status/1360697814293053447?s=20

Mebh posted:

You know I do wonder about the whole raging of old people about "doing Britain down" and being proud of the empire and our history stuff.

I've never bought into it because I grew up with the Internet and made as many friends across the world from various other cultures as I did in real life. I find the idea of being proud of Britain screwing people over and "one upping the forrins" appalling as these are my friends. They're not some nameless terror over the hills coming to steal my resources.

I felt the same about us with the vaccine supply. Vaguely sick and not really surprised that the one thing we're good at is screwing someone else over. Especially if they're a minority from another country.

Is it just as simple as the Internet divide? Unfettered access as a kid to talk to other people across the world then as a result feeling comfortable enough to go live abroad for a decade as an adult.

Versus your standard tory voter, never viewing other countries or classes of people as anything but a needy scrounging set of others who would take all your poo poo if they could.

Jose posted:

cool of the independent to publish this


https://twitter.com/drbobgill/status/1360697814293053447?s=20

peanut- posted:

Not gonna read the article but insurance based is not the same as for-profit or private. Most European countries use state insurance based healthcare systems, the NHS is an outlier.

peanut- posted:

Not gonna read the article but insurance based is not the same as for-profit or private. Most European countries use state insurance based healthcare systems, the NHS is an outlier.

peanut- posted:

Not gonna read the article but insurance based is not the same as for-profit or private. Most European countries use state insurance based healthcare systems, the NHS is an outlier.

Jose posted:

even so it would surely cost an absolute poo poo load to implement and for what reason?

Jose posted:

even so it would surely cost an absolute poo poo load to implement and for what reason?

Libluini posted:

It will never be completed. If they're dumb enough to actually try building it, the EU will soon after stop laughing and use political pressure to stop the project. And if Dictator Johnson stubbornly continues the project, it'll be blown up by French depth charges long before completion. Or the UK just collapses under a blockade, whichever happens first. Either way, the idea is dumb and stillborn. It's pure graft for whoever can get the money to then not build anything.

peanut- posted:

I suspect very little reason, the idea that there’s some magical reorganisation we can do to get wildly better results for the same spending is mostly misguided. If Germany or France has better healthcare than us it’s because they spend more, not because a state insurance system is somehow much more efficient.

Endjinneer posted:

I think there's people who respond to empire-pride who grew up in the years after the internet and after joining the EU. Nigel Farage was 9 when that happened, for example.
My suspicion is that it's down to a) the deeply ingrained desire to be a "winner" and b) having little else to point to that justifies that status.
If your quality of life has been so low that your totem of self-worth is a woggle you got for earning the most badges in cubs aged eight. What does it do to you when someone tells you the scout promise was creepy and Baden Powell was a war criminal?

Darth Walrus posted:

One of NI's problems is the emerging trade barriers between it and Britain, so it would at least help with those.

bitterandtwisted posted:

https://twitter.com/davidclewis/status/1360870718418870272

Prospect posted:

Does the NHS really need another reorganisation?

Nobody doubts the health service is in a critical condition. But more “reform” could turn out to be no cure at all

2020 was the most difficult year in the NHS’s history. 2021—so far—is hardly better. But 2022 already looks more familiar: the NHS appears set for another major reorganisation.

Last week, a draft government white paper on planned NHS legislation—complete with helpful notes such as “[ADD FURTHER DETAIL LATER]”—was leaked online. The timing will feel odd to many, but the idea of reform hasn’t come out of nowhere. The leaked white paper follows a series of requests by national NHS leaders in England for changes to NHS structures and legislation—first in 2019, before the pandemic hit, then again in late 2020. The government’s full white paper on reform is due to be published imminently.

So why do government and national NHS leaders think changes to legislation are needed? Broadly speaking, there are two things going on here. One is a set of technical policy changes wanted by NHS leaders to encourage collaboration in the health system. The other is political changes proposed by government to increase ministerial control of the NHS. Both reflect familiar debates about how the NHS should be run—and both would dismantle major planks of Andrew Lansley’s controversial Health and Social Care Act 2012. It’s worth taking each in turn.

First—the more technical changes. For NHS leaders, the rationale is that legislation is needed to make it easier for NHS organisations to work together to improve local services. Although David Cameron had promised an already reform-weary health service an end to top-down reorganisation, Lansley’s 2012 Act—the last round of major NHS reform—sought to strengthen competition in the health system, and created a complex and fragmented NHS structure. The bill had a painful passage through parliament, compromising the blue-print, but nonetheless produced such big changes that—in the words of one former health service boss—you could “see them from space.”

Lansley’s reforms, however, didn’t turn out as he had hoped. As funding was squeezed, NHS leaders embraced collaboration over competition and created their own informal structures—which in current guise are called integrated care systems (ICSs)—to join up local services. But these partnerships have no formal powers, and collaboration can still be impeded by the competition rules in the 2012 Act.

That’s why NHS leaders want to reverse key elements of the 2012 Act—including removing requirements to competitively tender some NHS services, scrapping clinical commissioning groups, and formally establishing new area-based bodies to make decisions on local priorities and spending (which, for keen observers of NHS history, will look a little like the old strategic health authorities—or even the older area health authorities created in one of the early rounds of NHS reforms, way back in 1974).

Encouraging collaboration to improve services makes sense—and there is a need for legal changes to tidy the administrative mess left by Lansley’s Act. But the benefits of integrating services are perennially overstated. There are also risks. Merging and creating new agencies can cause major disruption. And however logical each round of organisational changes may seem, the cycle of NHS reform can drain staff energy and confidence. The proposals are also not clear on how ICSs will work in practice—just how much power will they have over hospitals, for instance?—and the role of local government in the new system proposed is poorly defined.

So what about the more political changes? Here the rationale for reform is less clear. The 2012 Act sought to reduce political interference in the day-to-day running of the NHS. Ministerial involvement didn’t disappear, of course—Jeremy Hunt, for instance, held Monday morning meetings on the detail of NHS performance—but NHS England, led by Simon Stevens, became the de-facto Headquarters for NHS strategy. And it seemed to work: the NHS gained a clear vision and enough independence to make the case for extra funding; and long-serving health secretary Jeremy Hunt claimed he never felt he “lacked a power to give direction” to the NHS when he needed to under the 2012 Act.

Matt Hancock must feel less powerful than his predecessor. The leaked white paper marks a shift back towards ministerial command and control of the NHS in England. The draft white paper includes a range of powers to strengthen the Secretary of State’s grip on the health care system—including powers to direct NHS England, rejig national NHS bodies, and intervene earlier in the “reconfiguration” of services.

The draft document seems to claim that the pandemic has illustrated the need for these changes. But evidence that stronger ministerial control would have boosted the NHS’s pandemic performance is hard to find. Do they really believe it? Another motivation may be to establish a narrative, ahead of any Covid-19 public inquiry, that arm’s-length bodies—not government—are to blame for England’s pandemic performance. Whatever the logic, the government should articulate much more clearly what concrete benefits we can expect from the changes. It should also explain why much needed reforms to adult social care in England appear to be being ducked yet again.

The challenges facing the NHS and its patients over the rest of the parliament are enormous. In the short term, hospitals remain under major pressure and primary care is racing to vaccinate the population against Covid-19. When these pressures ease, the NHS must address the vast backlog of unmet health care needs, fix chronic workforce shortages, and tackle health inequalities that the pandemic has only worsened. Will a reorganisation really help to meet these challenges? Let’s hope so. But evidence from past reforms is not promising. And the risk is that major reorganisation destabilises services and diverts time and resources away from what matters.

Hugh Alderwick is Assistant Director of Policy at the Health Foundation

Mebh posted:

I really miss German healthcare. Mostly because every private practice was available and wait times were practically nothing.

Thanks to the thread a month or so ago I started investigating the possibility that i have ADHD. I talked to a private doctor through work (we get 6 free consults a year) and he said "hmm, sounds like it." wrote me a referral and it cost me a tenner.

Rang my GP and they said yeah you'll have to talk to a specialist but we don't recommend it as the wait times are 12 to 18 months. Can you afford private?

So I paid for private out of pocket because gently caress continuing like this. £550 for an assessment (moderate combination type! Yay) £250 for each follow up (up to 6 of which might be needed depending on how I adjust to medication) £unknown for the blood and ekg tests I need to get meds and £50-100 a month for medication depending on dosage. It's frankly eye watering.

In each eu country where I had to live with the wife and had no insurance til all the paperwork cleared for a few months it was significantly cheaper and people were absolutely horrified at the cost because all medication should be free. With pharmacists insisting we kept receipts and paying us back later.

In Germany wait times were stupid short and if you didn't like it, you went to a different doctor. Netherlands was a bit different and more restrictive but still stupid fast and Spain we were on their NHS equivalent which felt more like queuing at a meat counter with a ticket to see a doc but worked really well... As long as you didn't try to ring them, ever.

peanut- posted:

I suspect very little reason, the idea that there’s some magical reorganisation we can do to get wildly better results for the same spending is mostly misguided. If Germany or France has better healthcare than us it’s because they spend more, not because a state insurance system is somehow much more efficient.

Kin posted:

So, heating chat. With the winter being colder at the minute, we've been having some heating issues and trying to save costs.

I was wondering, for those of you who've got central heating with a hot water cylinder, do you put them on a schedule or just leave it on all day or all night or something?

Failed Imagineer posted:

Get a Google Nest thermostat, then your boiler fiddling drops to almost nothing, and when you do need to it's just a swipe on your phone

Breath Ray posted:

i like the collaboration bit. the ministerial control bit seems self-serving.

Jaeluni Asjil posted:

I expect the system has changed but in the late 1970s I worked in Germany for a while.
We had compulsory private health insurance paid out of our wages.
One of the limitations though was that they didn't really have much of a GP type system so you sort of picked the specialist you wanted to see so if you had a 'referred' type symptom, you might not get adequately directed.
On the other hand, you got an appointment almost immediately and if you needed hospital treatment, you got sent along the same day.

I have no idea what the system was like for those without an employer paying health insurance out of wages.

Jaeluni Asjil posted:

*who needs a smartmeter when they have eyes and a spreadsheet?

Mebh posted:

I really miss German healthcare. Mostly because every private practice was available and wait times were practically nothing.

Thanks to the thread a month or so ago I started investigating the possibility that i have ADHD.

Tsietisin posted:

So I was the same except I had Bupa private health insurance. Their paperwork States that they cover mental health issues so I rang them to get an appointment with one of their ADHD psychotherapists.

Only I got told that they don't cover that mental health issues as it's a learning disability and they won't pay for me. So all the money I had paid into the plan was pointless.

And that's the problem. You can be denied the healthcare you want because some person with the purse strings days so, not whether it may be medically necessary or not.

Also, when I ended up in hospital with Sepsis (caused by an sore tooth that a private dentist refused to treat) the insurance company provided me no extra. It was the NHS that kept me alive.