bridge too far

Sorry I come across that way Nick. Old? Yes. Bird? No, I'm a woman. Patronising because I'm trying to explain how the NHS works to you, since I've had to learn this for myself as part of the various jobs I've done in the NHS? Guilty as charged. I don't think I can be accused of being flippant about waste though as it has been my job *****il retirement) to audit and report on the very waste you're talking about. I wouldn't have lasted in my job if I'd ignored this. In fact, I very quickly rose through the ranks from office manager to Project Manager / Procurement Manager / Principal Auditor in the space of 10 years so I must have been doing something right. All I'm trying to do Old Nick is to suggest to you that things are not always as they seem in the press and that there's often far more to a 'story' than meets the eye. If you were to tell me about your business and how it runs, I'd respect what you have to say because you know more than me about it. Please accord me the same respect. Stupid swear filter won't let me type ( until )

Cracking game!

http://www.saintsweb.co.uk/showthread.php?30283-sleeping-disorder

Nothing yet here either

Horlicks oh and don't drink alcohol beyond about 7pm http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/sleepproblems/sleepingwell.aspx

You really do dig yourself into some holes buddy. The reasons we need more money in the NHS are many and varied. For example: 1. The demographics. People are living much longer and, because of that, developing illnesses associated with old age such as dementia, eye problems, mobility problems to name a few. 2. The advances in medicine and surgery. I've mentioned it many times before but my mother's prescription drugs for leukaemia cost around £30K a year and she was taking them for about 7 years. Not too many years ago, she wouldn't have survived that long because the drugs hadn't been discovered. So she alone 'cost' the NHS over £200K before she died. If you ever watch and understand the hugely complex multi-disciplined surgery undertaken these days (often involving teams of 10 surgeons, let alone all the associated clinicians) you'd realise where money goes nowadays. Such surgery wouldn't have been even thought of even just 10 years ago. 3. Diagnostic medicine. MRI doesn't just require the hugely expensive kit. It also requires specially constructed buildings with RF screening. That doesn't come cheap. 4. The public's desire for such things as single-sex wards. Once upon a time a Nightingale ward had 14 beds and required staffing by a (shared) sister, a staff nurse or two and a number of nurses and health care assistants. Single sex, ensuite rooms require a more intensive nursing complement because patients aren't easily monitored from a central station as before. 5. Remote diagnostics and telemetry. Doesn't come free. Do you NOW see how it all pans out?

I always think that these sorts of situations are hard to judge from afar. Usually, in this country at least, the Daily Mail will argue for retributive justice e.g. chemical castration of paedophiles and rapists. So I guess their stance is because it's a Muslim country imposing such justice. And we're the first to moan if, for example, another country (or EU) tries to impose its laws to override our national laws. But some feel we have the right to do so in other countries. The poor woman - I can well understand her wanting revenge for such a barbaric act. But do two wrongs make a right? I would have thought imprisonment to be good justice. As I say, tough call and I can see both points of view.

Why don't YOU report it to the Chief Executive then? Why don't you become proactive outraged from wherever? Or, alternatively, why don't you sit on your hands and do the square root of f... all but, instead, make childish retorts? Yeah that's the thing to do:facepalm:

He should ask to be tried and sentenced over here - chances are he'd only serve 15 months if Ken Clarke's proposals go through.

Maybe things are hotting up (although it doesn't mention Poorsmouth http://www.bbc.co.uk/news/uk-england-13439915

Nope - doesn't work like that. Each NHS Trust has a database of properties owned and leased. Not only does this database give information about rooms, sizes, covenants etc but it also has condition surveys. The NHS Trust is charged in keeping all property to a certain level (Condition B) and the asset register prompts annual reviews of both usage and condition. I don't know anything about the Christchurch building you refer to (not living in the area) but I did find the reaction from NHS Estates managers to the original Sky article http://www.hefma.org.uk/news/item/28m-a-year-spent-on-empty-buildings You will see that it coincides with what I was saying. 1) Buildings are put up to serve the purpose at the time. Needs change * 2) They've been trying to get out of the contract but have been unable to do so. You say offer half-rent - supposing the leaseholder doesn't agree. What then? 3) and finally: "But you can't deal with this easily during a recession. If you were to flood the market with empty properties you would simply devalue them, so it has to be done over time. There's no quick fix." This problem will soon be exacerbated when further estates become surplus to requirements following the abolition of Primary Care Trusts. (I wonder if Lansley has factored that into his costs of reorganisation). * Once upon a time, people were in hospital for a week or a fortnight following simple surgery. These days, dependent on the procedure, more than 70% and in some cases 100% of operations are carried out as a day case. Equals fewer beds - equals fewer buildings. Plus, without getting into further debate, the concentration of surgery into specialist units and the use of community hospitals as step-downs prior to home nursing / nursing homes also means fewer buildings. So you see - one building remaining empty doesn't a summer make! You need the facts and understanding behind the headlines.

Because Nick you can't just walk away from leases as you well know. Only today I'm reading about Mothercare shutting hundreds of shops. Their spokesman said 'luckily many of the leases are due to expire'. So they won't be liable for rents on those shops. I had a shop - when we looked into moving to larger premises we were hindered by the lease on the existing shop. In the current economic climate, it's a very difficult job to get rid of property no longer required. I've seen waste in the NHS many times. I used to audit the NHS FFS! The worst case? When I was a procurement manager and had negotiated a big contract at very good prices for hip and knee joints. It was to no avail because the orthopaedic surgeon managing the department wanted us to continue to use Exeter hips and knees, even though they were way more expensive than the ones I'd sourced. Because that's what he'd always used! And he carried more clout than me. Nonetheless, during my time in that job, we managed to secure 6% savings year on year on the non-pay budget. There is waste in all industries and service sectors. I could equally complain about inefficiencies in the private sector that cost me money and about which I have no choice. I'm currently in dispute with a kitchen manufacturer about a cupboard door that has been replaced 3 times and is still wrong. I dread to think how much that has cost in terms of their time, the fitter's time, my time. Somebody will be picking up the bill for that. Not me, but future customers no doubt.

Coming from someone who has more phobias than anyone else I know (xenophobia being just one) I find myself feeling really sorry for you. I would have thought that the very fact that I said I had two FRIENDS called Tim (who are both gay) demonstrates that I have no irrational fear or antipathy towards homosexuals. But I guess you don't understand the word 'friend' - probably an alien concept to you. Since you are also calling me a 'little Englander', I can only assume that you are attempting an ironic jibe. Didn't work little man.

ho·mo·pho·bi·a    [/url]/ˌhoʊməˈfoʊbiə/ Show Spelled[hoh-muh-foh-bee-uh] Show IPA –noun unreasoning fear of or antipathy toward homosexuals and homosexuality. So where does this thread show unreasoning fear etc. etc. etc.?

Explain how this thread is homophobic. In words of one syllable if that's all that you can muster.

Aaahhhh now that's a different matter entirely

And there YOU go Nick - repeating the Tory mantra. What personal illustration do YOU have of waste (from your own observation, not from something you've read)? You weren't able to name any redundant buildings for me I notice. What experience do YOU have of how to run a hospital or even a hospital's department? I don't know what line of business you're in, but I bet you'd be pretty ******ed off if I started criticising your way of doing business without knowing the slightest thing about it. I would hazard a guess that your experience of the NHS is as a user? Well, I use Marks and Spencers but I haven't got the foggiest idea of how to run it. It's a bit like what happened to us this morning. Half-way through our Waitrose shopping when the fire alarms went off. We had to wait an hour and a half before we could get back into the store but you wouldn't believe the number of moaning minnies criticising the staff for not letting them in. Did they understand what was really happening? Did they bu$$ery - they just came out with stuff like 'oh I expect it's some jobsworth holding things up'. (It was no such thing - it was an electrical fire in the ceiling void). But hey ho - they knew best. Prats! I'm not on a guilt trip. I'm just praising the NHS for what it does so brilliantly. Jeez, I bet children in countries without an NHS wouldn't get such amazing treatment (probably wouldn't get ANY such treatment unless they had wealthy parents) It's a shame more people don't praise this wonderful asset we have instead of constantly knocking it.

Too simple Nick. Sorry you choose to generalise instead of trying to understand the practicalities of situations. As you say, I know how hard it is in the private sector. I also know how tough it is in the public sector and how frustrating it is sometimes. But, until I retired, I was back in the private sector but auditing the public sector - the best and worst of both worlds. From this most recent experience I can tell you that NHS managers (many of whom are still practising clinicians) work as hard as they can to deliver value for money. It's just that the likes of the Tory party and its clarions the Torygraph and the Daily Heil choose to overstate and exaggerate minute details because they are driven by an agenda. If, like me, you watched the excellent 3 part series on children's cranio-facial surgery at the John Radcliffe Hospital in Oxford, you would have wept with humility at the sheer brilliance of the procedures carried out there - all for free thanks to our NHS. I was privileged to have worked on the project that delivered that wonderful centre and I can tell you it is served brilliantly, not just by surgeons but by countless support staff including administrators, porters, cooks and cleaners. Oh, and managers without whom the centre would struggle to carry on its day-to-day tasks as well as its outstanding surgical procedures.

The analogy doesn't make sense. One would expect Poopey to be fined for transgression as precedents have been set. The expectation of a reasonable person. One would NOT expect an unbiased political opinion from Alistair Campbell because he is paid to have a political opinion. To have such an expectation would show a degree of naivety, to say the least.

If so, were they fined for doing so as per QPR?

Oh, and another thing NickNick If these stupid Lansley 'reforms' go ahead, there'll be even more redundant property with the disbandment of strategic health authorities and PCTs. There will be, at the same time, a demand from GP consortia for additional accommodation to house all the administrative staff they're going to need to do 'local purchasing'. Unfortunately, the vacant properties will not be in the right places to satisfy the requirements of the GP consortia as the GPs will require expansion to their surgeries or additional rented office space near to their surgeries. So that'll probably eat up a few million in additional office rent. I don't defend the indefensible. But I do speak from experience. Unfortunately, too many people make pronouncements without actually understanding the situation. I'd probably include Andrew Lansley in this.

But Nick, you'd be the first to moan if the NHS BOUGHT office blocks. NHS Estates managers DO have an asset register that includes owned and rented property. They DO try to dispose of redundant assets where possible. The problem is that constant reorganisation (by governments of all hues) means that properties are leased to satisfy current needs and then no longer required. They can't just walk away from leases and, if you look around any town centre, you'll see that there are a lot of empty commercial properties - there is an office in my town that we were interested in and it's still empty after 3 years. So sub-letting isn't as easy as it seems. I worked for two NHS Trusts' Estate departments over 10 years and I can assure you it's not as cut and dried as you're trying to make out. I don't know of any Estates managers sunning themselves in Spain (and I know a fair few). An Estates manager responsible for an estate of 3 hospitals and various leased offices would be lucky to earn £40-50K a year so his / her pension (probably £10K pa on average) wouldn't go far.

I have two friends called Tim, both of whom are gay.

What empty property are you talking about Nick? Two things you need to know. Firstly, some redundant NHS buildings are on sites that have covenants on them. If you were to drive along the Woodstock Road in Oxford, you'd see a huge swathe of land in the city centre, apparently unused. It's the site of the former Radcliffe Infirmary that has now relocated to fit-for-purpose buildings at the John Radcliffe Hospital. The site HAS been sold but it can only be developed by a health / education body. So - to those who know nothing about what's going on - it looks like an unused space. Secondly, some old hospitals were paid for by local charities and fund-raising groups. The NHS doesn't necessarily OWN the land on which the buildings sit, rather it leases the land. So even if the buildings are empty, it's not the NHS that can dispose of the land. Oh, and even if the NHS DOES own some redundant land / buildings that it CAN sell, the price it could realise isn't particularly good at the moment. So - which buildings are you talking about as a for instance?

http://www.bbc.co.uk/news/uk-england-london-13420587