Author Topic: Outsourcing Adult Services to a “Social Enterprise” organisation  (Read 10461 times)

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Offline 20Eyes

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No sure I can agree with you about the NHS being a sub standard health care provider

If only it were simply about our personal views. Unfortunately, it's not. This highlights the very issue I'm making, though; people in the UK have been told 'NHS? It's the best in the world' so many times that they actually believe it - despite it being very far from the truth:

http://www.google.co.uk/search?hl=en&safe=off&biw=1131&bih=692&q=nhs+ranking+world+healthcare+league&aq=f&aqi=&aql=&oq=&gs_rfai=

Every piece of serious research that's been done on the subject has concluded that the Bismarck system produces superior results, yet we doggedly stick with the Beveridge system. To my mind, there can only be one (very bad) reason for that.
 
and I’m sure your girlfriend, who I assume from a previous post of yours, has spent time in the states, might agree with me if you compare the level of health care service provided free (at the point of use) in the UK to that in the states.

A previous girlfriend lives there (as she's American), so knows a fair amount about it. She has excellent free health care available - as do many Americans. Again, most British people seem to think America has no free health care... it's a myth. I've used their free health care myself (NOT under travel insurance) and it was excellent, a marked difference between attending NHS A&E, I can assure you.

I strongly believe that NHS has become a victim of its own success. The more technological and medical developments improve both the quantity and quality of life you can expect the more people expect from it. Many of these developments result in more expensive treatments along with the level of care needed and thus the cost of the NHS rises.

Agreed, the model no longer works as it should. Reform is not only desirable but becoming essential.

I don’t believe that any government has truly kept up with the real cost of a fully funded for ALL NHS service. This I believe is why doctors and consultant regularly have to make decisions, often based on moral rather than medical reasons, why one person will not be getting a particular treatment whilst another person will be.

As per your reasons above, it would be near impossible to sustain a fully funded NHS for all.

It's all very sad:

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Taxpayers are now getting poorer value for money from the NHS than they were 10 years ago.

Productivity - the measure of output per pound spent - has fallen by almost 14 per cent in hospitals since 2000, it concluded.

Over that timescale the annual NHS budget has increased from £60 billion to £102 billion, a 70 per cent rise.

Hospitals' absolute output has increased significantly. But the NAO's report, Management of NHS Hospital Productivity, found it has not kept pace with the extra cash pumped into the system

http://www.telegraph.co.uk/health/healthnews/8206972/Billions-spent-on-NHS-salaries-as-productivity-falls-National-Audit-Office-finds.html

An almost incomprehensible amount of additional money chucked at the NHS since 2000 and productivity has fallen by 14%? Nobody, but nobody, can view that as anything but a system in failure. Time for a change.
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Offline Ringer

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Bogo made a good point about the funding, but isn't that what NI is for? Paying for prescriptions applies to England but not Wales or Scotland, why is that?
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Offline Des Moffatt

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Been catching up this morning.
Western Councillors were not at the meeting due to the date having been changed, without any consultation I would add and for no reason that we can identify.
Social Enterprise. The Labour group as a body are extremely anxious about this.
Whitehall has determined that this will happen and it will.
A leading Labour member described the decision as a bad day for the NHS while another said this is simply a transition vehicle to transfer the non clinical work of the NHS and Social Services to the Granny Farmers. The proposed board of the Social Enterprise will contain just one elected person.
I have taken the view for some time that Labour can not simply stand by while the Tory party fixes the rules so that the social enterprise fails and there becomes no alternative available but the private sector.
We need to be in a position to understand what is being proposed.
We need to avoid any excuse to exclude our members so for these reasons the only logical approach was abstention.
Des Moffatt

Offline Rochelle

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Apologies to all for my tardiness, Christmas preparations got in the way over the weekend ( camping in Savernake Forest Christmas Eve til Boxing Day so preparations pretty crucial!)
However, I have had a bit of time to try and frame my response so here goes...
I should probably start by saying that I worked in Adult Social Care during the Thatcher years and saw first-hand the heartbreaking results of ill-thought out and poorly-funded policies. So I'm extremely concerned that our current situation is aimed at "finishing the job". I am fortunate in that doctors run in my husband's family so I've been able to canvass people I know from across the political spectrum whose opinions I believe I can trust. This includes my stepson, just about to complete a gruelling stint in A&E who is right-leaning politically.
Their insight has been really helpful and that along with my conversations with professionals in the field here led me to my decision to abstain last week.
Apart from anything else, the decision was taken at a meeting which had been re-arranged rather late in the day so a fair number of councillors were not in attendance, undermining the democratic process, in my opinion.
As Bob pointed out, the Labour Group only had the presentation on Monday, which didn't leave much time to deliberate on a matter as important as this. I should add that, as a member of Health Overview and scrutiny, Scrutiny and the Joint Commissioning Board, I had the information sooner than some.
As Andy Harrison stated at last week's scrutiny, quite correctly, a question asked was not fully answered.
At Thursday's meeting it was stated that as councillors we are obligated to ask questions and inform ourselves so that we can take decisions not "sit on our hands" Absolutely, but if you ask questions but don't receive the answers, then what? Should we really be voting on something when we are not clear what we are voting for (or against)? Surely that is highly irresponsible?
I accept that their is some urgency and decisions do need to be made, but frankly I do not accept that the current speed with which everything is being approached is entirely necessary. It could however, be interpreted as political expediency.
So, if I did not feel I could vote for, why not vote against?
As we all know, there is quite a bit of willy-waving in the chamber...I am uninterested in that, and will never be bullied, heckled or insulted into making a decision that I am not morally comfortable with. I intend to be a thoughtful, considered councillor rather than a knee-jerk one. I will not vote to suit someone else.( I am absolutely not pointing the finger at anyone in particular here!).
To simply say no, I feel, is to slam doors shut, not least in my own mind. We are where we are (I may be quoting our dear leader here!)
There are some things we cannot change and must work with. I want to remain a part of the process, not put myself outside of it. I want to, hopefully, play a part in protecting what can be protected.
I am not prepared to simply reject anything out of hand. The reality is that we were asked on Thursday to vote from a "choice" of one option, there is no plan B. Although in my considered opinion it is the least worst option,I could not blindly vote yes for it on that basis.
Or...maybe I was simply "whipped" into abstaining...



Offline Bogomil

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Des and Rochelle
Sorry to sound pedantic, (and I also appreciate that Des was not there) but once in the chamber are you not voting on the motion that has been tabled in front of you? (Or any amended motion)

If this is the case then if you believe that there has been insufficient information or answers to questions that have been asked, or that the motion before you is something that you can not support, then surely you have a duty to vote against it as an abstention may be seen to indicate the an ambivalence or mild disapproval of the motion.

I do not see how voting against a motion that you are not content with can been seen as “slamming the door shut”. Had the majority done this would the administration not have had to come back with an alternative or more detailed proposal?

Offline Chris Watts

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Des and Rochelle
Sorry to sound pedantic, (and I also appreciate that Des was not there) but once in the chamber are you not voting on the motion that has been tabled in front of you? (Or any amended motion)

If this is the case then if you believe that there has been insufficient information or answers to questions that have been asked, or that the motion before you is something that you can not support, then surely you have a duty to vote against it as an abstention may be seen to indicate the an ambivalence or mild disapproval of the motion.

I do not see how voting against a motion that you are not content with can been seen as “slamming the door shut”. Had the majority done this would the administration not have had to come back with an alternative or more detailed proposal?
Bogomil, I did not realise over 11 Tory's on the council voted against the motion or abstained. I must have taken my eye off the ball for a moment. I was sure all Tory's voted in favour with the addition of one Lib Dem.

Offline Bogomil

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Chris
Appreciate that you are trying to defend your colleagues who were in the chamber, but I did qualify the point with “Had the majority done this….” as there may have also been some Tories voting on a party whip.

Offline Rochelle

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As I said Bogomil, this is just my perspective. We are all informed in our decision-making by our individual characters and life experiences. For me, there is is life outside the chamber. It is just one aspect of "the job" and in all honesty, I think we'd all be a lot better off if some people stopped playing at politics and just got on with the really valuable stuff. As a middle aged woman with 35 years of political activity behind me I stopped sabre-rattling some time ago. It's fun, but not necessarily productive. I no longer see things in black and white either, although some would disagree with that! I realise this may not answer your question as fully as you would like but whilst emails and on-line forums are very useful I find they can sometimes be a barrier to clear communication, particularly if you are a highly emotional person (which I am, it's no doubt a terrible pain for those who have to live with me).
There's nothing better than a real conversation with a real person where all the other communication tools we possess can be employed!
I will do my best though if you want to continue so feel free to come back at me!

Offline Tobes

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A previous girlfriend lives there (as she's American), so knows a fair amount about it. She has excellent free health care available - as do many Americans. Again, most British people seem to think America has no free health care... it's a myth. I've used their free health care myself (NOT under travel insurance) and it was excellent, a marked difference between attending NHS A&E, I can assure you.

A myth eh.  :santa_azn:

Ah, the 'I'm alright Jack' attitude spilling from 20Eyes keyboard once again. I know some Americans too, Mr 20. Several of them can't afford the high cost of meaningful health insurance (and by meaningful, I'd invite you to do some proper research, rather than trotting out glib far right wing cliches or basing sweeping statements on your own fortunate experience - by 'meaningful', have a read of the exclusions in many policies, and assess for yourself the massive hikes in premium people suffer if they suffer from any congenital or long lasting illness). Many of the self employed - or those who income is uncertain, live in fear of illness to an extent that it almost paralyses what they do, because they know that any kind of illness might literally kill them for want of treatment.

But hey, lets just let the facts speak for themselves:

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The U.S. Census Bureau reported that a record 50.7 million Americans—16.7% of the population—were uninsured in 2009.[1]

I'm alright Jack...?

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More money per person is spent on health care in the USA than in any other nation in the world,

Oh, thats good then! They must have wonderful healthcare! Except -

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A 2001 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses

and the small issue of...

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The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy, though the relation between these statistics to the system itself is debated. Currently, the USA has a higher infant mortality rate than most of the world's industrialized nations. The United States life expectancy lags 42nd in the world, after some other industrialized nations, lagging last of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th).

Oh, I see! Excellent heathcare only applies to the rich - we should scrub the poor from the stats when we talk about the excellence of the American healthcare system!?

As for the 'free' American healthcare on offer - what are you talking about? This?

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Government programs directly cover 27.8% of the population (83 million), including the elderly, disabled, children, veterans, and some of the poor, and federal law mandates public access to emergency services regardless of ability to pay.

So,  you and your girl were lucky enough to fit into the 27.8% then?

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Some Americans do not qualify for government-provided health insurance, are not provided health insurance by an employer, and are unable to afford, cannot qualify for, or choose not to purchase, private health insurance. When charity or "uncompensated" care is not available, they sometimes simply go without needed medical treatment. This problem has become a source of considerable political controversy on a national level.

But don't take my word for it - have a read for yourself (references are provided) - http://en.wikipedia.org/wiki/Health_care_in_the_United_States
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Offline Des Morgan

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Western Councillors were not at the meeting due to the date having been changed, without any consultation


Hi Des - I assume Derique agreed to the date change, perhaps he should have said no to Coun Bluh.

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but if you ask questions but don't receive the answers, then what?


Ah Rochelle - then you make yourself a pain in the arse to all and sundry until you get your answer.  I actually never set out to be 'public enemy number one' at the Civic Offices but if that's what it take to get an answer to a question then that's what I will continue to be. It is a sad fact that some councillors lack the moral fibre to actually ask the tough questions, having said that I am also sure that some councillors don't read the papers they are sent and sit looking bemused as a subject is presented and 'debated'.

Offline Des Morgan

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There's nothing better than a real conversation with a real person where all the other communication tools we possess can be employed
!

By communciation tools are you referring to 'sitting on hands', 'willy-waving', 'knee jerking' , finger pointing and being 'whipped' - sounds more like an S&M session rather than a Council Meeting  :santa_shocked:

I only jest - you are of course quite right in that meeting face to face is much better. The problem is that the people concerned still will not listen to a  logical argument or accept their position may just be wrong

Offline Rochelle

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But one day Des, one of them just might...and then it will have been worth all the effort!
Actually, I think S&M may be a good deal tamer than politics....at least people generally abide by the rules with S&M...

Offline Rochelle

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And yes, of course you keep asking the questions until you have the information you need to make an informed choice. As my Nan would say, there's more than one way to skin a cat and I believe my approach will prove more useful to the people of Swindon in the long run than voting in haste, to make it easier for others...Of course I could be wrong.
As for councillors not reading their papers, well I have it on very good authority that you are correct and it drives hard-working officers to despair! Although I may not be referring to SBC!

Offline Chris Watts

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Chris
Appreciate that you are trying to defend your colleagues who were in the chamber, but I did qualify the point with “Had the majority done this….” as there may have also been some Tories voting on a party whip.
I think I was being factitious in fairness.

When is the last time that you witnessed a Tory backbencher vote against a Tory motion in full council? I can not remember seeing one do this in the year that I have been in attendance. Therefore the "had a majority done this..." quote is academic and as likely as monkeys flying out of my ear.

(I did witness, at a cabinet meeting, Cllr Edwards vote against the bus lane in Ermin Street, contrary to all the other members of the cabinet. Call me cynical, but as Ermin street is in his ward, and several ward members were present, I suspect that he got permission first as it did not effect the outcome. I am sure that is not the case really.)  :santa_afro:

Offline 20Eyes

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So,  you and your girl were lucky enough to fit into the 27.8% then?

You do realise that's well over 1 in 4 people? Hardly a tiny minority. BTW, the person I was referring to that lives there is a self-employed designer in Portland, a town that has a relatively poor economy but a massive amount of designers. She rents a small two bedroom condo with her friend. She's far from what anyone would describe as well-off, I can assure you. She actually moved out there from the Mid-West as part of the JVC, so knows a lot about the amount of free healthcare that's available in the States - there really is a lot more of it than you might suppose. What you don't hear about, over here, is the sheer amount of finance donated by business and individuals to organisations that offer such free services. It's something we should be aiming to copy over here, rather than constantly sneering at the US system of healthcare.

Unlike you to seem to assume, I am not suggesting the US healthcare system is perfect, ideal or even desirable - I merely pointed out that it is nowhere near as bad as vested interests here in the UK would like people to believe.

I honestly know people in the UK who are so brainwashed by pro-Left/NHS propaganda that they actually think people in the States are left on the street to die if they can't prove they can afford their medical treatment in advance.

Unfortunately, and very unhelpfully, the pro-Left/NHS lobby in the UK always starts screeching about how we have it better than some other countries and so therefore mustn't dream of changing anything to do with the NHS. It's one of the main reasons our healthcare service peforms so woefully against virtually all other EU and comparable nations. It's very sad that people are happy for it to be slightly better than the worst, rather than as good as the best.

We're being hugely short-changed, mainly due to indoctrinated ideology, that's very clear.
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Offline Ringer

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Will administration costs increase under a Social enterprise? It was bad enough in the NHS, but a council and the NHS combined could be worse?

Department of Health figures show that in the four years ending last year, the total amount spent on administration went from £1.43 billion to £2.14 billion - a rise of 49.5 per cent.

The statistics, which cover the period from 2004 to 2008, show that the total spent on managers went from £566 million to £808 million, a rise of 43 per cent. Spending on other administrative staff increased by 78 per cent, from £606 million to £1.07 billion.

I await to see the running cost projections.

Middle-class families are to lose an average of £10,000 each over the next four years as a result of the package of spending cuts and tax rises unveiled in the Coalition’s Comprehensive Spending Review.  Households with an income of more than £48,000 will each lose about five per cent of their annual earnings by paying thousands of pounds extra in tax while losing benefits and access to public services, Treasury figures indicate. Is this a new type of socialism?

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Offline Tobes

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I honestly know people in the UK who are so brainwashed by pro-Left/NHS propaganda that they actually think people in the States are left on the street to die if they can't prove they can afford their medical treatment in advance.

That very much depends upon what illness or condition that person is suffering from. Ever wondered why there are so many hobos and street beggars in the states?

They're not necessarily 'brainwashed by pro-left/NHS propaganda'!!! Many of us who are very much opposed to 'leftie' ideology have the evidence of our own eyes, not to mention friends of our own from the States and are quite capable of forming our own opinions based upon a reasonable assessment of the facts.  I had a friend in the states who injured his hand in an industrial machine. Because he was doing unpaid work (on a project of his own) his employers insurance didn't cover him. He was taken to hospital, they checked his insurance, they injected him and stitched him back together - but then literally turfed him out. No physio, no out-patient care offered, no reconstructive surgery - nowt without cash up front. You're right that you aren't literally left to bleed to death on the street, but anything other than emergency care has to be paid for - up front if you're one of the people caught between your 27% and the 50+ million Americans who are uninsured.

There's very good reasons to sneer at the American health care system, one which is predicated not according to any hypocratic oath or a sense of social cohesion, but disproportionately about profit and greed.

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It's something we should be aiming to copy over here, rather than constantly sneering at the US system of healthcare.

So, you've just chosen to ignore the fact that its the most expensive healthcare system in the world but delivers a life expectancy well below that of the UK and most of the rest of the EU?

That a 2001 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses?

That by any gauge seems to show me that instead of accusing anyone who disagrees with you of having been brainwashed by 'lefties' that you might consider whether or not you've been indoctrinated by right-wing Express readers and Murdoc appologists...

The credit crunch has demonstrated the moral emptiness and ultimately ecenomically doomed rational of the kind of capitalism which revolves around unregulated privatisation. There has to be a balance. The American extreme is NOT a good example of a 'good' healthcare system.
I do not agree with what you have to say, but I'll defend to the death your right to say it - Voltaire 'Entia non sunt multiplicanda praeter necessita

Offline 20Eyes

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I'll say it again: I'm not claiming that the US healthcare system is good, just that it's not as bad as it's portrayed over here or as bad as some people over here are led to believe.

The point I've been trying to make is that it's not good blithely saying, 'The NHS is better than what they've got in America', as if that means it's all perfectly acceptable.

Your rush to lambast the US system tends to reinforce what I'm actually saying. It shouldn't be about 'better than the worst', it should be about, 'as good as the best' - which it isn't.
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Offline Mellon

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US Healthcare system?! What a friggin joke my little brother smacked his head on a coffee table and needed stitches, cost 149 dollars.....seriously a feckin joke. If you don't have insurance and you can't afford the treatment your fecked
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Offline Steve Wakefield

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Middle-class families are to lose an average of £10,000 each over the next four years as a result of the package of spending cuts and tax rises unveiled in the Coalition’s Comprehensive Spending Review.  Households with an income of more than £48,000 will each lose about five per cent of their annual earnings by paying thousands of pounds extra in tax while losing benefits and access to public services, Treasury figures indicate. Is this a new type of socialism?

All I can say is that it must be a comfort to people knowning that they will not have to pay medical bills during a period of austerity.
All posts on this forum are my own and do not represent the views of any council or any political party.  :banana:

 

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