PoliticsJOE reacts to Keir Starmer's NHS "reform or die" speech

[@drppenev]

As a doctor working 10 years in the NHS every day, I spend 40+ minutes a day turning computers on, fighting with a printer, or waiting for some ancients software to load. And this is if everything is working as usual, on a bad day it cluld ne much worse.

[@enemystand2981]

I used to be an optom, and I only had to do a few hospital shifts in my time. The communication framework in this country between us and the hospitals was genuinely shocking.

[@djohnston6856]

I am required to print reports for a task in colour. I have no access to a colour printer. The colour printer is in the locked office of staff who are not entirely office based. We are not permitted (a trust level ban) to buy or install any new printer hardware.

[@shaunreid6851]

@@djohnston6856 Good, printing should be done as an absolute last resort and Colour printing cartridges are obscenely priced. You need to look at the process and get the need to print them off in the first place removed asap.

[@geniemarie7977]

​@@djohnston6856😮

[@geniemarie7977]

​@@shaunreid6851😢

[@losnino4515]

A party left of Labour is needed,

[@julianshepherd2038]

💚

[@julianshepherd2038]

🍉

[@taykitrleevitt4314]

Corbin was the man you're talking about and the UK told him to f-off... they say you get the government you deserve and the UK voted Tory for 15 years... the present state of the UK is a result of UK electorate decisions.

[@markysgeeklab8783]

@losnino4515 Lib Dems are left of labour now :)

[@willieclark2256]

@@julianshepherd2038 a serious party

[@Glasgow_kiss]

hows about taking the profit to private companies out of all NHS areas, from hygiene to bureaucracy, from cafeterias to consultancy. millions flow out of the NHS every day. and labours plans are to use *more* privatisation. that didnt work with PFI and it wont work now. nationalise all areas of the NHS let the contracts run out, zero cost.

[@chester6343]

Nationalising stuff in the UK or anywhere tbh is generally just a disaster waiting to happen, unions end up going rogue and holding the country to ransom, who needs that in their life.

[@markysgeeklab8783]

@@Glasgow_kiss when PFI wasn't working, they knew they had to make a change..... so they rebranded it as PPP :)

[@1ForTheShieldz]

Time to reduce doctors pay and give nurses a fair share. Make them.all employees not contractors!

[@djohnston6856]

@@1ForTheShieldz a band 6 nurse gets more than a junior doctor

[@jonsmith5058]

@@1ForTheShieldzthe issue isnt the Doctors. Its the private companies doing the maintenance, cleaning, catering, you name it. We had our internal maintenance guys forced into working for the private firm when we moved to a PFI hospital. Previously, they could just help. When I asked for stuff in the new build the guy literally adviced me that he’s forced to charge me £80 for any task, even if its just popping in a nail to hang a clock… Stuff like that needs to go internal to remove the profit motive and bring common sense back.

[@grimsbyhackney479]

I heard someone say this on the radio today (I don't know who it was and I am paraphrasing I think) "We want European style services but American style taxes". I reckon that tells us a lot of what we need to know to understand what's going on.

[@davidkavanagh189]

Problem is that we are heading in a direction of European style taxes and American style services. Similar problems here in Ireland and other European countries. Taxes the same or more(in real terms) than years gone by and a noticeable continuous decline in public services with a greater and greater need for the likes of private health insurance and paying out of our pockets for private services.

[@cad4246]

Aging populations. Drives up the healthcare costs.

[@jackoh991]

Who says we want less taxes? I think that's a myth the right made up

[@leonardeast4971]

Pedal fear set the young against the ageing population is a very dangerous game.​@@cad4246

[@1ForTheShieldz]

Problem is we are getting American health on European taxes!!!

[@peer2pirate]

Just listened on Spotify - the BMA is not a trade union, it's a professional accossiacion. One big difference here is that BMA works to ensure/protect standard of care as provided by the medical profession. When doctors strike it's not just about money, but about the conditions they have to work in and the degradation of the care they provided as a result of those conditions. Many consultants never go on strike out of a sense of duty to their patients.

[@croneryveit9070]

Didn't you just describe a union while saying BMA is not a union? Engineering unions also ensure the output of the profession is safe and consistent with contemporary standards while also making sure the workers are protected for example. Literally from BMA's official website; "The British Medical Association (BMA) is the trade union and professional body for doctors and medical students in the UK.". Idk what the point you're trying to make here is.

[@BobbyJobling]

I think you are confused

[@TinTin01234]

I think you mean unprofessional, not professional

[@anewsortofgramophone]

There’s no news in the Darzi report, certainly for anyone working in the NHS. The three goals could have come out of a primary school focus group and, again, are obvious goals that have been about for decades. What are they actually going to do?! Also, the threatening discourse towards the NHS reads as “you are not working hard enough or efficiently enough” when staff are sick and burnt out and deserting in droves. This felt really hopeless and insulting. It is much more about the systems that connect with the NHS than the NHS itself - social care, education, prisons, police, underfunding of local/community services, etc. the crumbling NHS is the last stop for the sickness of the nation.

[@paulh7736]

Does the NHS going digital mean Fujitsu get a massive contract and then I get randomly marked as dead, or will it be Capita and they leave everyone's medical records on a bus?

[@andyevans8585]

Lol it's both sad and hilarious that those are genuinely the most likely outcomes...

[@markwelch3564]

Palantir are out there too - you will still have a two year wait, but Amazon will have special offers ready to help ease your symptoms...

[@jackoh991]

Or ATOS and they claim I don't need a wheelchair because I can unzip a backpack?

[@andyevans8585]

@@jackoh991 oh jesus...

[@jackoh991]

@@andyevans8585 lol I know. It's unbelievable isn't it. Oh and they said I couldn't be disabled because I had a job (despite not actually being able to work full time in a decade)

[@ChrisWBarker]

The third reform is the friends we make along the way(?)

[@jackoh991]

Community care but under a different name😂

[@garethatkinson2549]

Is the IT digitisation going to be outsourced to Fujitsu? Maybe it will repeatedly tell doctors patients don't have cancer, when in fact they do...

[@markwelch3564]

It's legitimately terrifying when you think about it - is there any organisation large enough to tackle NHS IT that _isn't _ tainted by some kind of scandal or corruption?

[@garethatkinson2549]

@@markwelch3564 it does need to happen though, even though there is a high chance of project mess up.

[@Gudgeify]

They should tender each region of the country seperately so private companies can bid for the contract and ultimately cause a 3 way split in digitisation systems and methods. This definitely didnt happen a few years ago when the tories f*cked the digitisation of health records.

[@jonsmith5058]

Hot take. But the digitization has always been a white elephant and too big. You can’t go paperless, humans are too complex and standardised forms miss out a ton. Medical staff always write outside the lines when weird stuff comes up. This is what always doomed it to fail. Its much more efficient for them to use paper than a tablet (which quickly got lost or stolen). We need a hybrid approach, scanning in documents to make the records electronic after, and not have one huge IT system, but smaller, dedicated ones, that can talk to each other.

[@sebzim4500]

Call me elitist but junior doctors should obviously make more money than a barista.

[@anthonylulham3473]

Yeah someone whos trained for 7 years, intensive work ethic, huge responsibility, is holding people as they die, is being attacked physically in hospital, yeah they should be paid more than the person who trained for 4 hours on the coffee machine. not all work is equal. not all workers are equal. the doctor who saves lives is more important than the barista who makes a coffee, and the doctor should be paid more.

[@matt99is]

You can't reform anything without investment kier.

[@MadnessQuotient]

"We don't know what #3 is" "He talks about moving from treatment to prevention a lot" #3 is focusing on prevantative care.

[@TheGreatMoss]

Joeurnalism

[@anthonylulham3473]

@@TheGreatMoss KEK

[@julianshepherd2038]

Starmer wants to privatise

[@1ForTheShieldz]

Exactly, he is worse than tories!

[@djohnston6856]

When talking about cyber attacks please clarify if the service targeted is an nhs service or if it was a private company running nhs services. The recent cyber "nhs" attack was actually against a diagnostic service owned by Seeco. Pathology and laboratory services are in line for the chop and it has already begun. But because they're not medical staff it goes completely uncommented on.

[@ieuancare945]

Reform 3: moving to more prevention of sickness so there's less sickness to treat. A long-standing aim

[@enemystand2981]

I feel like considering we have such a colossal cultural entitlement that we can’t even stop ourselves from getting in needless fights to hurt each other for the sake of it, that this is far too massive of a goal for us

[@markysgeeklab8783]

That's what I came here to say. WTF are these two blethering about having 1 missing!

[@anthonylulham3473]

Will there be food rationing to get the obesity rate down? oh, people wont be able to afford to eat! Kier Starmer is truly a Genius.

[@GoikOShea]

The 3rd goal is blaming people for getting sick.

[@djohnston6856]

FFS! Nursing? What about physiopherapists, chiropodists, pharmacists, occupational therapists, biomedical scientists, geneticists, physics technicians... and more and more. All these services are undergoing active privatisation and as long as everyone talks about the NHS as a service run entirely by doctors and nurses it going to keep getting sliced down to nothing.

[@anthonylulham3473]

Because those specialisms are niche. if we had to say all of them in the same breath then we'd never finish a sentence. thus doctors and Nurses to cover the lot.

[@djohnston6856]

@@anthonylulham3473 I'm not saying list them all, but a lack of nuance and the language used is aiding privatisation.

[@Michael_Milne]

30 years ago we were discussing in school how BMI was an ineffective measure of health...

[@Bhaalgorn2302]

Was at the hospital yesterday to talk about some test results. Couldn't get my data on their computer, couldn't connect to my GP for my health records, couldn't pull results from the other hospital 10 miles away where the tests had been done. Doc rebooked me in for 8 weeks time so she could have paper copies of everything sent to her so we could talk about the things she should have had on her screen with a few button clicks. One wasted appointment, a second one taken that could have gone to someone else and several people in several places now need to print out and mail a bunch of paperwork for no reason just because the NHS computers don't work.

[@Ghengiskhansmum]

GP's and NHS are not connected. You need to authorise permission. If you move doctors surgeries you also need to authorise permission for them to access your records. You cannot do it by phone it must be written and signed by all involved. We haven't modernised, we've gone full Victorian within 4 decades. Thatcher started it all.

[@operationgoldfish8331]

7:40 - The majority of winter hospital admissions that end up 'bed-blocking' come from care homes, because communicable diseases transfer more easily in a shared accommodation setting. The classic situation is that their place in the care home is filled and the result is a long wait while another place is found. People in care homes are not going to be affected by winter fuel allowance changes. Starmer was hinting at handing the social care responsibilities back to community care and (presumably) increasing funding for that sector, which would reduce the winter burden on hospitals. Not saying that the benefit gap produced by means testing is a good thing, but increased bed-blocking is unlikely to be a huge consequence.

[@hilaryporter7841]

The cutting of agency staff the fastest change of all. Surely Labour needs to research this subject rather more closely before Starmer jumping to that very fast conclusion. It's no accident that the NHS has been forced to use agency staff. Government has cut budget for training for in house staff. They should not cut agency 'before' putting something else in place. Starmer lives in cloud cuckoo land.

[@nazb1982]

Digitisation fine. Since the care sector is also broken how is moving care to the community going to work?

[@Ghengiskhansmum]

The care sector is mostly private businesses. They've been sucking the life out of the industry for decades.

[@rosemarycuthbert4623]

Like schools never teach healthy eating, lifestyles etc. Teachers have been doing this for decades. Poor children and parents can't afford healthy food

[@HA05GER]

People go on oh it's cheap to eat healthy. Absolute tosh, I know not the healthiest meal in the world but I bought the stuff from Asda this week for beef stroganoff beef was £9, 2 peppers at about £1.50, 2 packs of mushrooms at £2 ISH, seasoning about a £1.50, rice £1 and some milk. So £15 or I could of bought 2 bags of chicken nuggets at £1.10 each and 2 bags of potato pops at £1.10 each and a couple tins of beans. So about a fiver. I've been there we've been through hard times because they if my health and had to do a shop on £50 and it sucked and all shite. Now we are in a better position and try to heat proper meals not necessarily super healthy but avoid all the artificial crap. Fry stuff in olive oil or lard. If we want battered chicken we get the fresh stuff without the added crap. If we have a spag bowl then make our own sauce. It's not hard to eat healthy but it is hard to afford healthy.

[@enemystand2981]

@@HA05GERa-fucking-men

[@jablot5054]

​@@HA05GERdon't eat meat, save even more.

[@demejiuk5660]

@@HA05GERAbsolutely disagree. But you do have to know HOW to eat healthy and cheap. What do you think poor African, Chinese, Indian and Turkish families eat? I’ll tell you it’s not beans and chicken nuggets. £9 for beef? With a £10 I could get all the meat id need for a month and stick it in the freezer. Alot of minority communities can eat for cheap because 1. They buy things like Rice or pasta in bulk. 2. They cook sauces in bulk (sauces with a vegetable and meat base). Nigerian red stew for example. 4x tins of plum tomatoes. 2 onions. That’s less than £2. For less than a fiver you could get 2 packs of chicken (quarters, thighs or drumsticks) those prices can be found in Lidl, Aldi, Morrisons and even Marks and Spencers has cheap chicken. That’s £7 all together. That would feed you for a week. You could get 10kg of rice pretty cheap if you scout around and that will last you months. I know this because that’s how my family ate when I was a teenager and we got given a tenner to do the weekly shop. This was 1999 so obviously with inflation it’s not exactly the same but the principles were the same. Rice and stew 2,3 times a week. Bolognaise 2 times a week. Another similar bulk meal 2-3 times a week.

[@cad4246]

It's also the time, not just the money. Working multiple part time / zero hours jobs to pay the bills leaves little time for meal planning and prep.

[@jasonking2976]

I seem to remember that #3 was prevention; thus banning junk food adds etc. I suspect that the real #3 is private insurance schemes,but then I am an arch-cynic.

[@wanglord9591]

Can you imagine if our military services were dependant on the same computers as our NHS hospitals? The discourse would be unbelievable.

[@tbrooke3016]

Omfg Ava is so right about the hackers not bothering. I'm a software dev and the field is filled with HUGE egos especially among hackers. They want to take on a challenge especially if it will get them huge public attention without identifying them specifically

[@Nonya_T.]

The entire thing is oxymoronic. Reform, by Startmer's own definition, must include reversing most austerity measures. Look at health outcomes of kids in poverty because of the 2-child benefit cap, for one thing. Reversing these insane measures would be the most straightforward win in terms of prevention.

[@3D_Printing]

PRIVATE HEALTH CARE the push; if you have the cash you can have health

[@robertmccann9631]

I think the issue with the IT is a procurement one. You have dozens of trusts all bidding with different IT companies for contracts and machines. Realistically as its public sector your always going to go with the cheapest option and that isn't wholscale IT reform. YOU probably need centralised procurement and ironically more money 💰 invested to get everything at the same level.

[@anthonywilson8998]

Try bed numbers reduced by 50% while the population has increased by 10 million. This is the main problem and a massive bottleneck to everything in and out. We have only 30% of the beds in France and Germany.

[@nomoreheroes93]

The opening chat in these pubcasts always sound like an awkward first date - also 24:45 is a silly take, of course junior doctors should be paid more than a barista, not all jobs are equal

[@chester6343]

A Barista can charge what they like and if you let capitalism do it's thing the market will decide what they're worth to people.

[@anthonylulham3473]

@@chester6343 And the doctor is locked into a socialist system, should we let the free market decide the doctors wage? No? you want affordable healthcare? you like the NHS? maybe make sure junior doctors are paid better than no skilled workers. its not that the Barista cant make £40k a year if they hustle. Its that Doctors should be on more than that because they are hustling too and have lives at stake.

[@chester6343]

@@anthonylulham3473 yes, when the NHS was being formed doctors made up a large part of the opposition due to the obvious dent it was going to make in their pockets. Affordable healthcare is a total moot point to me as I pay a pretty large NIC every April, which and not that I want to would easily pay for insurance. The NHS is not fit for use these days unfortunately. It's got a workforce in the top 5 global employers.. 1.5m people, it's insane how expensive it is and a hell of a lot of the people working for it aren't badly paid either to be honest.. also, no such thing as a junior doctor.

[@imkjvc2302]

@@chester6343I’ll go tell my mate who’s a junior doctor he doesn’t exist, thanks for the insight 😂

[@GordonTorbet]

Content-wise. very interesting and relevant - I’m a huge supporter of the NHS and a long-time loather of all privatisation efforts. It would be good to know who the presenters are and what qualifies them to comment on the topics under discussion (not just this pod). We need to know that the information and viewpoints/critiques are from authoritative sources. Also, that’s a. If table in a wide shot! Couldn’t they move slightly closer together and look a bit more natural?

[@fireh3211]

You will need a "big" tech company that will manage that digitized data. He said he won't increase funding to the NHS, so money that should be spend on healthcare workers will be moved to the tech industry instead. By tech industry (private sector) it's probably not in UK.

[@shaunreid6851]

when you have no idea what you are talking about its probably best staying quite. The UK has massive Tech industry and has all the innovation needed already, the NHS just needs funding to purchase and resources to implement.

[@fireh3211]

@@shaunreid6851 what do you think about injecting IT project into insufficiently funded NHS without increasing investment?

[@samreeve9738]

A complete systems overhaul with a central unified database is much needed, and would facilitate proper records, enable the mobile app to provide up to date and comprehensive data, and generally cut down on the wasted time. Not to mention the invaluable data that could be mined to aid research and spot patterns. Obviously this is a pipe dream, but we can dream right

[@shaunreid6851]

Its actually exactly what the NHS is working on with limited funding.

[@googlesucks6029]

So glad I decided to have a pint instead of voting for Labour. Unfortunately I lived in one of those areas were it was either vote for Labour, Tory or waste my vote.

[@rosemarycuthbert4623]

Is the ship the Titanic 😅

[@markysgeeklab8783]

It's the Britanic! (Titanics sister ship that was converted into a hospital ship in WW1 then sunk after hitting a mine)

[@dannevirkenz]

Does everyone remember what a success the last IT system for the NHS was like under Labour? Maybe if we tried from the bottom up reform for a change, instead of the managerial/consultant top down method we may get some results. I am not sure that further reform and change is going to give the change that is needed.

[@callum9999]

The nursing tuition fees come up a lot, but I don't think there is a demand from people wanting to be nurses who are unwilling to pay the fees. Scottish fees are very low - they still had vacancies in clearing this year. The Welsh NHS fully funds tuition fees - they still had vacancies in clearing. English students are given £5k per year (so the tuition fee is effectively £4250/year) - they had vacancies in clearing. These figures are trivial for starting a career (not least because they're fully covered by Student Loans) - the problem is absolutely the salary once qualified. The only way to get more home-grown nurses is to pay them to study (nursing apprenticeships - where you're paid a full-time wage while studying - are becoming bigger and bigger) or drastically increase the wages. I feel like neither of those is going to happen in a meaningful way, leaving the only option to recruit more from abroad - despite the apparent hatred the country has of immigrants right now.

[@Tastyweasels]

Huge fact check on teaching. I was given £25k without tax and after training didn't earn that again for 4 years. (In terms of take home pay)

[@MadnessQuotient]

Increasing NHS funding without raising taxes on working people is easy. 1. Delete the UEL on NI. That isnt a tax rise it is the removal of a discount for rich people. 2. Increase Employer NI rates. I say double them, but cringe "pro business" politicians would likely wimp out on that. If we were to switch to a private insurance solution, employers would be paying much much higher rates to buy insurance policies for their employees. So for people who advocate low taxes and private healthcare this should not be controversial.

[@cad4246]

Those are both taxes on workers. Taxing an employer more per worker leaves less to pay the workers. We need to shift to wealth taxes. Completely revamp council tax into a property or land value tax, with some consideration for total household wealth. Tax second homes. Close loophole on inheriting pensions. Bring back lifetime pension allowance but relink it to inflation. Value defined benefit pensions in a realistic way, which would push many above the lifetime limit.

[@jimpaine6331]

As I understand it, company directors pay no national insurance at all, on the spurious grounds that they take less than the threshold amount in salary, and the rest in dividends which do not attract NI. I personally know of at least two handsomely remunerated people who pay no NI at all. Have I misunderstood and if so is there anyone with the expertise to see the record straight?

[@michaelrch]

Taxing employers NI is not ideal as it could make struggling businesses sack people. Taxing profits is muuuch better. It takes money from companies that have too much. And it takes money that would otherwise go to shareholders rather than workers.

[@petermanuel5043]

Hmm... Maybe just get given a book. Your doctor just writes in this book and stamps it and signs it. You take it to the next doctor. Maybe they scan or take a photo of the book in your appointment.

[@tomg268]

That’s how it works in China. Easy to lose though - i’d rather there was an online system.

[@HA05GER]

We have them for children the little red book. My son has autism and we have family services involved part of social services as they may be able to offer help. Now they have no access to his health record which seems absolutely insane.

[@donkey_oaty]

“The NHS doesn’t get hacked” Or they just don’t have the ability to notice.

[@LimeyRedneck]

I think the third was linking health and social care which I've only heard about for 28 years 🙄

[@famiyunbokino]

Calling BS on the anologue doctors stuff. Doctors using pen and paper and entering things into old computers hasn't happened for years. Doctors have been using dedicated software for many years now and apps like Patient Access or the NHS app have your full medical history.

[@cad4246]

Yep, have been a bit ill this year and been to GP and had a few tests. Both NHS app and patient access are great. Test results in the app saves the surgery calling me. Online appointments frees up the phone line for those who need it. Get a prescription, walk less than five minutes to the pharmacy and it's already there. I think the reason you repeat yourself is the doctor doesn't have time to read the history between the last appointment and next one.

[@shaunreid6851]

Exactly these too are very ill informed. Its patchy but a lot of the digital problems they describe no longer exists.

[@weeksy79]

Big finance/tech companies get through computers at a crazy rate, why not do a tax incentive that allows them to donate their 3-5yr old computers to the NHS

[@shaunreid6851]

As an NHS employee whose trust has a 5 year kit replacement programme I'll pass thank you. These two are talking nonsense about old kit, it might exists still in isolated pockets in the NHS but most now have a good standard laptop or desktop device.

[@stevemc81]

#3 fixing royal mail Letters arriving after appointments?

[@JustME-ft4di]

They need to sort help for ppl with Chronic Illnesses that are nit related to life style choice. There is no support or help at all and there are millions of us who cannot work.

[@jackoh991]

And many who could work if we were given healthcare!

[@jackoh991]

BTW underhanded to make the lifestyle choice comment. Everyone deserves care

[@JustME-ft4di]

I agree! There are lots of things that are preventable / curable if the NHS did it’s job though and everyone has a responsibility to take care of their own health. In the end it is all we have.

[@jackoh991]

@@JustME-ft4di sure but most people who don't "manage their own health" it's because of an existing health condition or because of poverty. Hence it's not a very fair comment. Few people choose to be ill

[@repairupdaterepeat5815]

Don't shoot me because I genuinely don't know...... But would love to see forces medics doing front line stuff lol I lived next to an army medic when I was little and was sent to him after I busted my knee open coming off my bike. He taught me the way of medical adhesive 🤣

[@paulgilliland2992]

Good luck running your facilities without agency staffing. This is what happens when you have two tier medical systems and then one become dependent on another to bridge the divide. £5000 a shift is far from typical but sounds great as an attack ad. It depends on your specialty so that a pediatric oncologist is making more than a dermatologist. Makes sense to me

[@je-politics]

Most likely number 3 will be introducing policy which in turn will aim to reduce social factors that contribute towards bad health which will reduce the overall amount of people needed the NHS services For example … the smoking ban aiming to reduce long term health issues regarding young people the governments recent initiative to attempt to ban fast food adverts on tvs by next year All of these act as deterrents aiming to reduce health issues, a healthier society means less reliance on the NHS which overall benefits the system

[@MrFlamingo2002]

The country is having to go through a period of cold turkey, it’s an option of the truth or what we want to be the truth. Personally, the real truth is far more important, it’s relevant!

[@skymotel2]

Maybe he loves a metaphor because political commentators remember them and talk about them.

[@nickmannion3879]

Before the ususual suspects go off on one....the first person to put forward reform of the NHS, and I quote "For the NHS, we need to reassess the relationship between the public and the private" (it was part of a speech on nationalised industries and public services)...Blackpool Conference 1949....err Nye Bevan as it happens. So if it was good enough for Nye, why can't it be for Starmer/Streeting? See lots of 'yeah but no but' below...

[@shropshirewoodsman3222]

Someone's here for an argument...

[@Kohanman]

Bevan talking about reducing existing privatisation in healthcare industry this modern nationalised structure of the health service truly existed =//= Starmer talking about increasing privatisation in the existing structure of a nationilised health service. "but they used similar wording": context and intent are as important as the words, unless, that is, you want to pointlessly engage in some pedantic debate-bro sophistry in yt comments.

[@markwelch3564]

You're arguing that the brake and the accelerator are exactly the same thing, because they both change the speed of the car 🙄

[@1ForTheShieldz]

TTK AND LABOUR NEED TO GO!!!

[@colsylvester639]

A lot of the systems don't integrate with one another either at all or enough, so text appointment reminder systems for example don't work....as I've been told by family or friends in health

[@susieb1211]

There should be no place for profit in the nhs. Get it out. Invest way more money by taxing wealth.

[@kevbrown2532]

'whats changing' - sweet FA. Starmer having a number 3 isn't surprising, he does seem to enjoy a massdebate.

[@ahmedsamysheta2976]

From treatment to prevention

[@TheUnluckyGama]

That's how it worked in the early 2000s..

[@rosemarycuthbert4623]

Stop the boats and detain people who want to work. Really useful

[@idio-syncrasy]

Who chooses which journalist gets to ask questions?

[@Sausagerolex]

So he's switching to emailing letters, something every other organisation did just after the Titanic sank and mentioned a kid who's got an app to measure her glucose levels. I didn't hear anything else

[@rosemarycuthbert4623]

And the logistics for reform are ???

[@Ned-s8r]

Privatise hospitals and let private companies set up a lot more hospitals. Let them compete with one another for patients and profit. Which improves service and outcomes for patients. No competition no improvement. We pay more into our health service than most European countries

[@TheUnluckyGama]

That's worked so well with energy, rail and water... oh wait.. no it sucks...

[@TheGreatMoss]

Cameron made nhs trusts compete with each other for funding. This led to worse outcomes. Healthcare is a human right, people shouldn't be profiting from suffering

[@AlastairScarr]

Thats just a flat-out lie, we do NOT spend more money on our health service than other European counties. Privatisation does not equate to better patient outcomes, just look at America. A large part of the reason for the poor patient outcomes in the UK is because so much of the NHS is already outsouced to private companies. The NHS has in many ways deteriorated since (and because of), part privatisation.

[@ElemenTzEdits]

Lol have you just discovered neoliberal theory

[@anthonylulham3473]

On BMI - It is a good system built around a lethargic average person. Its not designed to work for the body builders. Its unfair for women with massive boobs because they weigh more than their A cup contemporaries. but in general its pretty good and obesity is the number 1 cause of complications medically. If you are a larger person who does lots of sport, you may have a better heart and lungs than a thinner person who stays inside and plays no sport. but for a general population if you have a BMI over 30 you can lose some mass. that's a 5'5 woman weighing 80kg, more than my heavily pregnant co-worker. that's a 5'10 man weighing 95kg (same as the England Rugby Backline but they are 6'2- score a 28 in the BMI.)

[@markysgeeklab8783]

The best thing he is doing that will save money is using the EMPTY, cheap to rent high street for basic medical stuff.

[@ol_playz]

Please make more parody songs

[@zakksez]

Inverse care law.

[@ellisridley9588]

It seems like the 3rd is a vague idea of prevention over treatment and an improvement to general health of the nation

[@shaunreid6851]

No the 3rd vision is well understood within the healthcare sector and can have a massive impact on efficiency and health outcomes it just needs investment and returns will be seen in the future. Its looking at things like weight loss drugs which in 5-10 years will drastically reduce the instances of Long term conditions and cancers. Earlier identification of cancers saves a lot of money compared to low success rates and high costs of treating advanced cancers. Better childhood interventions which drastically decrease the likelihood of lifetime conditions. Better identification and management of Hypertension reduces the instances of heart attacks, CVD and Strokes which all cost a lot more to treat. The diagnosis of and management of ADHD and Autism (which we now realise is massively undiagnosed in adults) will reduce depression and anxiety issues in the population leading to less mental health crisis. This is exactly the stuff we should be doing more of.

[@ellisridley9588]

@@shaunreid6851 I meant that the statement was quite vague on it. Not that prevention etc isn't real. No need for the essay.

[@ThePinwhite]

LOLs minimum wage isn’t £15 an hour girls but nice to imagine that being the case. Everyone should be fairly paid. I totally agree increasing those out of date amounts. yet the rubbish pay for junior doctors lasts for a period of time with the possibility of earning considerable amount more following that.. The barista as you say may well be earning close to the junior doctor, but no matter how many years working as a barista unless it has a company framework allowing promotion into higher management etc they are certainly not going to be earning anywhere near the amount of even a part time gp , I’m not saying they should but the progress does need to be acknowledged as a factor in raised salary and using the barista or service industry examples don’t seem to focus on the earnings following the junior years.

[@anewsortofgramophone]

Are we really going to compare this? Is there a world in which is fair to compare the two? How many days does it take to train a barista? 5 years of thousands and thousands of tuition fees for doctors! Crazy unsociable hours, insane responsibility, jail if you really mess up, leading a whole team of multiprofessionals, teaching, doing endless admin, quality assurance, research, all in the same day. Out of all professions, why shouldn’t doctors be paid large salaries? Juniors included! More money to baristas, yes, absolutely but come on!

[@jablot5054]

​@@anewsortofgramophonewhy is it always about even more money.

[@faves2064]

15 year old IT systems.....could be worse, could be Fujitsu 😬

[@alijones6610]

Access to services will be influenced by digital inclusion and how accessible and safe the design and delivery of those services are for different communities - so for people who can’t afford sustained access to the internet or share a phone with someone else, or who require alternative formats of communication , don’t have a permanent address or support from a translator or interpreter (as well as twenty billion other things that will impact access) you have a two tier healthcare system which will be further amplified by ‘digital transformation’. We need to stop talking about people from ‘deprived areas’ - it’s dehumanising. We need to talk about the practicalities of what resources people have access to, what barriers or oppression they experience, what support they have and how that impacts them being able to access and continue to engage with a service or care, as well as the experiences of the people who deliver the support and care.

[@jakeyapp1106]

Prevention is the third

[@benscox]

It was windows xp so 2001

[@warp5p1d3r6]

not sure labour will get two terms.

[@rossspenser8314]

Stupid PM it's not are war. Blame blame blame back back back

[@gothgurlfriend]

Why does Laura constantly pat her pieces of paper but doesn't actually ever move them or shuffle them...?

[@HazzyWazzey]

Great contribution to the debate mate

[@julianshepherd2038]

She does it to annoy pedents

[@TheGreatMoss]

Saw this comment, looked up, she immediately moved the papers to see the next page. You're a dunce

[@gothgurlfriend]

@@HazzyWazzey it's a debate? *pats piece of paper*

[@gamerfreakout]

Hard disagree about the bmi comments, being overweight is bad for health, this is known. Too many people trying to Not make people feel bad at the cost of their health.

[@LottieLoki]

It depends if you're "overweight" because of fat or because of muscle mass. Measuring the size of waist is a much more reliable way of determining health. Many athletes, body builders etc would be termed obese if you only looked at BMI despite most being demonstrably healthy under ever other measure. There's plenty of evidence that BMI is an unreliable measurement for health, nothing to do with feelings.

[@gamerfreakout]

@LottieLoki no body that's hench is saying ow no my bmi is too high while looking buff af. The average person that's just a bit over weight will here this and console themselves by saying yes but I'm healthy. Their is no health obese person or healthy overweight person.

[@gamerfreakout]

I agree it's a bad measure.

[@jackoh991]

Not true. There is evidence being obese is bad for health but not overweight and certainly not more so than underweight

[@martincheeseman5809]

Come on kier we are all with you!

[@DebatingWombat]

These 3 targets of Starmer’s aren’t really much of a plan. Moving from analogue to digital is just another way of praying for a technological fix. Sure, it might bring some benefits and/or efficiency gains, but hardly on a scale that will significantly impact some of the more serious, current problems in the NHS. Moving from hospital to community care sounds mainly like a way to rearrange the deck chairs on the Titanic. I haven’t heard anything about the issues with hospital overcrowding being people either being admitted unnecessarily or not being discharged quickly enough. Focusing on prevention is great, but hardly squares with his “fiscal rules” based version of “austerity light”, as prevention is not free either, Not to mention the implication of blaming sick people themselves for their illness, ignoring, say, the obvious and well-documented impact of poverty on health. As for his passive aggressive statements on the lines of not going to pay more and the need for change, I’m getting suspicious that this is a prelude to even more (stealth) privatisation by way of even more (sub) contracting, PFI 2.0 and/or “McKinsey’fication”.

[@basednuke7647]

why are they sat 10 miles away from each other what an awful set up

[@ChuffedDom]

This podcast is great. It's tiresome hearing the political ideology behind healthcare. But, it's all about the day-to-day operations of doctors, nurses, and surgeries.

[@josephmeldau7603]

It is so great when Ollie and Ed aren't there just talking absolute bollocks for the whole show. It actually feels like it's a politics podcast. Get rid of them and just let Ava and Laura do it every time from now on, please

[@rosemarycuthbert4623]

Private investors money will be welcome though

[@stephenstephen1505]

Starmer is a tory. He will introduce an insurance based NHS. Disgrace

[@krob2327]

Starmers wife is a grasper

[@djohnston6856]

Step 3 is privatisation of science and diagnostics. Welcome to cancer testing from Serco and Randox.

[@lilypad585]

As a 'junior' doctor who has been working in the NHS for several years now, some of Ava's comments re: our workload, our pay, comparing us to nurses, come across as ignorant. You don't seem to have looked into the structure of medical training in the UK or what that means for our pay and prospects. Please actually speak to junior doctors or research this topic properly instead of making assumptions. It is clear from what you've said that you feel paying tuition fees is appropriate for doctors because we somehow have a much better time of it than our nursing colleagues, and have more opportunities. Some aspects of this are true, but the way you talk about it is lacking in nuance. It is not simple to just go and practice abroad, it is not the case that we can just jet off and work wherever we want. We do not somehow have a better and easier time of it than our nursing colleagues by virtue of being a doctor. Most of us have to train for over a decade to even become a consultant, and in the meantime, we are paid poorly and deal with situations you will hopefully never have to face. It is not controversial or arrogant for us to be want to be paid more than a barista when we study for 5 years, train for many more, and work unsociable hours to keep people alive. The messaging is clumsy, but it isn't us "thinking we're so special" to want to be paid adequately. Our skills and expertise should be recognised, the work is fundamentally not the same as other jobs. It would be good if you could actually consider what our job is like and what it means, instead of implying we're arrogant for wanting better for ourselves.

[@krob2327]

You spend your life dedicated to a highly skilled profession. Don’t give internet grifters from wealth a second thought. How many lived do these people save? You could argue they encourage sedentary lifestyles and cult worship

[@benadams6019]

Day 54 of asking for a production team microphone.

[@jablot5054]

Why not means test health care. Why should rich people get it for free? Anyone on the 40% tax bracket should pay.

[@TheUnluckyGama]

Because actually the 40% bracket isn't that much anymore. Under your model a single person in 55k getting by should be wracked by huge bills if they get injured that could bankrupt them vs a couple both earning 48k who could both be injured and get treatment for free? This isn't a solution, it's division.. 14 years of tory cuts and under provision need correcting. It functioned fine prior to the Tories, which everyone seems to forget. The privatisation is costing far more than the NHS would, but the NHS is paying for it!!

[@jackoh991]

Lol. How many people would fall out of work immediately if you did that? You clearly don't understand maths

[@krob2327]

@@TheUnluckyGamait will just level down the middle class and leave the rich to be ok. Terrible idea

[@AJ-raps]

I can't believe she seriously asked "What's changing tomorrow?" 🤦🏿‍♂️ yikes!

[@TinTin01234]

Get rid of silly roles such as diversity managers!

[@5hif7yx86]

yeah im sure that will save millions. well done 😐

[@TinTin01234]

@@5hif7yx86 No. But it's a start.

[@ZoesMediaStudios]

In order for a better world, sometimes the old one needs to be torn down & rebuilt back up- The NHS

[@jonathankennedy1715]

Incompetent Liebour just wasted £20milllon tax payers Rwanda money.

[@HappyAwesomePower]

Care to explain Johnathan? This comment reads like a man man rambling.

[@PaulJohnson-zv3hl]

They only got another 19 billion 980 million to catch upto an average conservative year of waste then 😂

[@AntiPersonnelRescueAxe]

Please refrain from promoting the idea that being overweight equates to being healthy or leads to healthy outcomes. While it's possible to be overweight without immediate health concerns, it doesn’t mean you’re free from the risk of future health complications. As a nation facing an obesity crisis, spreading such misinformation can be harmful and misleading.

[@jackoh991]

You're getting obese and over weight mixed up

[@StjDUK]

Ok...Starmers speech specificaly left out the following: Taxing wealth correctly Taxing corporations properly Removing PPFI Not removing regulation for supply side financial services ( crash of 2008 anyone?) That digitisation marginalises rural communities who lack modern broadband ....wtaf do Starmer and Reeves seek to achieve outside of American style healthcare for profit? My first three points would fill that 22 billion hole on their own and more besides! Modern Labour are no different to the Tories.... Austerity 2.0

[@Red-px1fr]

Of course, that's all well outside the lane of his corporatist neoliberal agenda.

[@krob2327]

Ava cheers it on, she’s from wealth…

[@lukemorris9066]

White British ppl dont get access to it.... it honestly wouldn't shock me

[@MarkGriffin-h2f]

How many times did you say “like" whilst not liking? How’s Cressida, Portia et al?

[@krob2327]

Ava is from wealth…