buctootim

Im not sure about that. I think their catchment area population is smaller than Saints or Brighton as they are hemmed in on all sides. If we were all in the PL (I know, I know) I reckon Pompey would max out at around 24,000 even with a new stadium.

Oh I get it. Guns are are fun. Heroin is supposed to be amazing fun, so nice all you can think about is doing it again. Ive shot guns at a range before and would do it again. Its just a really really bad idea for the population to have guns at home in the same place that rows with neighbours and spouses take place and you also have curious kids.

They gang up on you too don't they?

Cameron's family seem to be ganging up on him! First his lawyer brother gets a trial halted over legal aid cuts, then his mum signs a petition against education cuts in Oxfordshire and now Aunty Claire is marching against austerity. Maybe the wrong Cameron is PM? http://www.theguardian.com/law/2014/apr/28/david-cameron-brother-legal-aid-cuts http://www.theguardian.com/politics/2016/feb/08/david-camerons-mother-signs-petition-against-cuts-to-childrens-services http://www.independent.co.uk/news/uk/politics/david-camerons-aunt-clare-currie-writes-to-warn-him-about-grave-error-of-cuts-a6876781.html

For me its that the lustre of the cups has faded - so having just one of them would make the remaining cup more special - unique even.

I cant help thinking that the pressure and and exposure of this trial and all the press is going to leave the girl in a worse place than if nothing had been done about it. I'd find it hard to recommend to my daughter she went down this route - although I hget the argument about protecting others.

He had to read every detail, twice, so he could be outraged.

Spuds are trying to build a new stadium for mega money. They will probably have to restrict spending on the team just as Arsenal did for five or six years in order to afford the Emirates.

Depends where you go in Britain and where in Sweden you are leaving. Huge contrasts within countries nowadays, probably more so than between European countries.

I genuinely think there are far fewer people living on benefits and not working than at any time in my lifetime. An awful lot of premature retirees on oversized pension pots though.

Agree. Its the Colchester v Man U games and the like which are unique and make it interesting. Just ditch the League Cup and keep the FA Cup as it is.

There are different arguments about the pros and cons of charging at least part of the cost. Paying something towards the cost of your own health care tends to make people value it more and not, for example make appointments and not bother to turn up. On the other hand having a charging mechanism just introduces a whole new layer to finance department of hospitals to raise and chase more invoices, making it less efficient. In France you have to pay between 23 and something like 50 euros for a doctors appointment and then claim the money back from two different bodies. I imagine some wealthier people cant be bothered and dont claim, whilst other really poor people dont go for an appointment because they dont have the 50 euros. I've heard (but havent seen confirmed) that in Australia they dont make you pay but do give you an invoice showing how puch your treatment cost - so at least you appreciate the value and treat the service with respect.

This. We watch incidents dozens of times in slow motion from different angles and still cant agree if Wanyama should get sent off - but somehow Clattenburg is an idiot incompetent. .

12.2m work in healthcare in the US, dwarfing the NHS even allowing for the population difference - but because thats across different healthcare providers people think there isnt bureacracy.

Sad but true. I still find it incredible the highest court in the land can be so openly politically partisan. My American boss thinks Im incredibly naive to believe our Supreme court is politically unbiased.

I'm not against privatisation per se - its not ideological - its simply that there are very few instances where a private company can genuinely operate healthcare more efficiently. Providing healthcare is not like manufacturing where you can come up with a more efficient means of production or design, or economies of scale, or source raw materials more cheaply. Its not like retail where you can reduce product costs by playing one supplier off against another or put lesser quality products in nicer packaging, or sell higher quality ones at bigger margins. You are employing doctors and nurses on nationally agreed pay rates, they are working to nationally agreed treatment protocols that shouldn't be varied. They are using drugs bought using a national purchasing consortium - which gets amazingly low prices compared to individual hospitals in other countries, far better than any private company will get. Where will a private company make the savings to fund a profit margin and pay for the contract managers which aren't necessary when you have directly employed staff? Most of the Private Finance Initiatives were a way of getting buildings and equipment now without putting up capital at the cost of very expensive maintenance agreements over 25 years or more. Yes you can contract out imaging (MRI, CAT X ray etc) to Philips, nuclear medicine to Siemens and get that nice new suite and scanner now - but it wont look so good in year 15 of the contract when the scanner is outdated and you have already paid more than you could have bought one outright for. I wasted 18 months of my work life at St Marys in London working with McDonnel Douglas to design a new computer system integrating patient records, activity capture, finance, clinics and pharmacy. They were gung ho when they came in, very bullish about how they conquered space - spent three years and £18m on it and admitted defeat. I don't work in the NHS anymore - I earn more money for fewer hours and get a more respect outside. When I joined it was still seen as a publicly valuable job. The needless political interference in the service and Daily Mail attacks about how ****e everything was has largely destroyed that ethos. That's why there is a massive staff retention problem, people leave a salaried job and go back as agency and earn three times as much or go to work for a private contractor which then sells itself back to the NHS. We may well destroy the NHS as it currently is. Only at that point - when the costs are 30% higher and the medical outcomes are the same will people realise what they had. Re a solution. There is no solution apart from either spending more or doing less. Getting to nirvana through efficiency savings is illusory. Demand for healthcare increase annually. At some point we will have to decide that there are cases where treatment wont be offered to certain groups or under certain circumstances.

A couple of things. At lot of the form fillings is the direct result of government reforms which changed the way hospitals are funded from a block grant based on catchment population size and demographics to be being paid per procedure / activity. So now you have to capture every contact with a nurse, tablet given, referral to doctor if the hospital wants to get paid. The other part of the form filling is an audit trail for anti negligence purposes - its part of the same culture whereby your bank has to give you a long disclaimer speech every time you report a card stolen or take out insurance. Again your assumption that the hospital doesn't know this is bureaucracy and does it for fun is wrong - it is simply operating to the system imposed on it, as any successor for profit business would have to. Is the NHS really one organisation? Sure the government want it to be accountable to a single CEO but in fact in England alone there are 209 clinical commissioning groups, 154 acute trusts, 56 mental health trusts, 37 community providers, 10 ambulance trusts and 7,900 GP practices - all with their own boards and CEOs. Is that a single organisation? Would it still be a single organisation if they were all for profit companies or registered charities? Does the NHS employ more staff than are employed by healthcare providers in comparable countries? (the answer is no by the way). The UK had 2.8 physicians per 1,000 people in 2013, compared to 4.1 in Germany, 3.9 in Italy, 3.8 in Spain, 3.4 in Australia, 3.3 in France, 2.8 in New Zealand and 2.6 in Canada. The UK had 2.8 hospital beds per 1,000 people in 2013, compared to 8.3 in Germany, 6.3 in France, 3.1 in Denmark, 3.0 in Spain and 2.8 in New Zealand.

Its just an endless merry-go-round. What the NHS really needs (and education) is to be left alone. I started work for the NHS at Brighton Health Authority in 1989 when it managed it own hospitals directly. By 1991 it had been merged into East Sussex HA still managing hospital but not GPs. By 1993 East Sussex and the other county Has were merged into South East England Commissioning Authority and the hospitals were now independently managed and there was a separate body for GPs. Soon it became clear some hospitals couldn't survive and they were merged into bigger NHs trusts and oh by the way regional commissioning is too remote so we need to do away with that and give more power to GPs and go local again. That took us up to about 1998 - five major reorganisations / changes under one single government in nine years. I left at that point but the reorganisations haven't stopped.

The French system is good, and they spend about 25% more than us. There are also a large number of charges which the patient has to pay, only some of which can be reclaimed. As Jonnyboy said, most of the critics of the NHS literally have no ****ing clue what they are talking about -- including many of the ministers who have 'reformed' it. It, along with education is one of the most messed about with, overloaded by government imposed bureaucracy organisations going. Despite that it is incredibly efficient. It is better than most health services which spend the same as us and not too far off many which spend far more. It does that by cutting back on hotel services and customer focussed access times - highly desirable but non core spend - building maintenance, catering, laundry, cleaning and out of hours working. Lets be clear about what efficiency means - it means delivering the maximum volume of healthcare to a good standard on a limited budget. In order to do that then managers deliberately over book clinics in order to save wasted slots because they know 20% of people wont bother to turn up or even cancel in advance. If you have to wait for an hour past your appointment, its not poor planning, its maximising effective use of resources. It also means minimising weekend or evening working, it means poor quality meals and relatively low standards of cleaning. Non of that is because the NHS is crap - its because its performing to the targets set for it on a budget 20-30% less than comparable nations. The idea is that more private business involvement is going to lower costs and improve efficiency is risible, beyond a joke. Its been tried so many times and proved to be a failure that its amazing some still believe it. At core you are taking NHS staff on minimum wage who are mostly motivated by a sense of working for the public good - and replacing them with a contractor who needs to make a 10% profit from the bid and operate with higher overheads - two sets of contract managers the NHS never had before. The contractor still employs the same staff because of TUPE and they are still on the same minimum wage. Guess where the efficiencies come from to make the profit and extra overheads? Service quality, its the only variable. It you want a health service like France, Germany and Switzerland the NHS can deliver it for you no problem, but you need to stump up 25% more funding. If you want to pay the same rates as Slovenia then be satisfied with healthcare only marginally better. It only seems to be in Britain that we are obsessed by the idea we can get something for nothing - that the reason for the shortfalls in the NHS is because everyone in it is **** and incompetent and the answer is to contract out to G4S and Sodexho. Utter utter bellends. If the Tories really ever got free reign to reform the NHS you'd end up the US business dominated model - as Wade Garrett said - a poor service at more than double what the NHS is costing now. That is what real business efficiency in healthcare looks like - phsyicians on $1m pa but neo-natal death rates and life expectancies poorer than Cuba or Costa Rica

So you don't care if a government minister is corrupt, untrustworthy and leaks information to favourite businesses?

But thats down to whoever does the rosta for the local trust. If the local managers doing the rostas aren't able to fill the gaps at the weekends currently they sure wont be able to if you increase the number of staff required to be on duty. As I said if anything it will increase the bill for agency staff.

Currently 20th out of 24 based on last six games. Just the sort of form we all hoped we'd see at this stage of the season http://footstats.co.uk/index.cfm?task=formguide

That doent make any sense. If you increase the required staffing complement at weekends but dont increase the number of doctors overall you will increase costs - it wont reduce the requirement for weekend agency staff.

Thats a supply issue - train more staff so there is more availability and reduce the need for expensive agency staff. Its a different issue to increasing demand (although obviously increasing demand creates need for more staff)

I dont see how these reforms will reduce use of agency staff, and afaik they arent intended to.