This poor management, coupled with the sheer evil of political decisions like that which affected Collette Mills, shows that the NHS is increasingly being run for the benefit of anyone except the patients. For fuck's sake, even the doctors are depressed. Even the politicians who have for so long used the NHS as a political football get little out of it as that ball swiftly becomes a millstone.
I believe that NuLabour have realised this. Unfortunately, they are handling privatisation with all of the competence and aplomb with which they have managed the economy: that is to say, extremely poorly.
I have long railed against PFI—a system that allows the government to keep capital expenditure off its books—which fails because it combines the very worst of the public and private sectors.
The reason that PFI has been such a fucking disaster is very simple: it combines many of the worst bits of both public and private sector behaviour. The advantage of PFI was that the private contractor would take responsibility for cost overruns and, of course, the Chancellor could pretend that he wasn't really spending any cash.
Unfortunately, the responsibility bit didn't take. The government could not let the PFI consortium go bust, e.g. in the case of Mapely Steps, the tax-haven based company that, ironically, bought and runs all of the Customs and Revenue Buildings, who had to return, cap in hand, to be bailed out.
Also, as Wat Tyler has consistently pointed out, the state is a Simple Shopper and is utterly outclassed by private sector negotiators when determining contracts.
And, since that Brown arsehole was so desperate to use PFI, private companies and the public commissioners would effectively collaborate on quotes to ensure that the private quote was cheaper than the public sector comparator. No matter that the PFI quote bore absolutely no fucking relation to the final cost, Brown wants PFI so PFI it is.
So, here you have the inefficient Simple Shopper, almost certainly indulging in the state's legendary tendency to shift the requirements several times during the project and effectively in bed with the companies bidding.
On the other side, we have huge companies, driven to make as much profit as possible, working projects for a client with an effectively bottomless wallet who cannot afford, politically, for the scheme to go wrong or the contractor to go bust or pull out. Further, the terms of these contracts ensure that the contracting company have an effective monopoly on the supply-side and running costs for massive installations for the next 30 years or so; in some cases, the contractor will still own the buildings at the end of that time, so the state will have to negotiate another healthy contract after that.
So we have companies needing to make money and essentially featherbedded from any kind of cost implications, the very thing that would normally drive efficiency in the private sector, and a naive, imcompetant and desperate state aiming to hire the company at any cost. It was always going to be a disaster from the taxpayer's point of view.
Now we see another example (which has been long highlighted by Private Eye) of the state being taken to the cleaners—or, if you prefer, "pissing our money up the wall"—because it cannot negotiate a good deal.
Private clinics carrying out NHS care are not seeing as many patients as they should, but they are still getting paid as their income was guaranteed.
Private treatment centres were set up to do minor surgery and diagnostic tests, in a bid to cut waiting lists.
Figures show that just four of the 25 such clinics created in the first wave of openings are doing enough work.
The government said the clinics would be making up the shortfall in work in the future.
There have been two waves of ISTCs (Independent sector treatment centres) opened since the concept was announced in 2003.
The clinics tend to concentrate on treatment such as knee and hip replacements, hernias and cataract operations.
Some are only doing 50% of the work specified in their contract.
What kind of fucking lunatic would negotiate such a contract? Are they insane?
If you want to keep the NHS state-run and state-funded, then fine; you're a fucking idiot, but no more fucking idiotic that sixty years of previous idiots.
If you want to take it private, then you are sensible (although let's look at all of the systems around the world and see which ones actually work), but this half-arsed compromise is just stupid. We have all of the disadvantages of both the private and public sectors and yet none of the advantages.
Make up your damn minds, you stupid fucks: this dithering is costing both lives and money.
