Specialists contracted to the NHS work their contracted hours within the NHS - the majority work well in excess of their contracted hours for no extra money. For their skill level these people are significantly underpaid. Private work is done in their spare time at no detrement to the NHS in fact it helps to reduce waiting lists. It also allows these highly skilled people to earn something close to their worth and prevents them working in other countries where the rewards would be significantly greater. Why is this morally wrong? what would be morally wrong is for someone to dictate what an individual can do in his or hers leisure time. They are not consuming NHS resource to do this work what is the issue?

What you are also saying is you want to tell people how they can spend their money - it is OK to buy a BMW or a Ferrari but it is not OK to have a hernia fixed when you want - that is morally indefensible. Life is not fair we all don't have the same intellect, physique, money, upbringing - something those with lefty leanings need to consider when trying to apply one size fits all.

sounds reasonable to me.

I happen to know one of these "specialists", he is employed within the NHS as a consultant (the medical use of the name not the bull business use) and his main contract of employment is within the NHS. He does some private work for the likes of BUPA in their local hospital but he doesn't see it as "spare time" work, his work is far too critical to just regard as "doing a guvvy job", and he earns significant sums of money within the NHS even before his private work, I know what he earns because he is friend of 40-odd years history with me and we call it like it is to each other, believe me, his worth to the NHS is well rewarded.

Interestingly he trained at the LGI in the 1970s, worked within the NHS for a while and then took a consultants role in private medicine in London in the late 80s when it looked as thought he NHS was dead in the water and private medicine was where it was at, his wage there was eye-watering but ultimately he admits that he spent the effing lot on a lifestyle that matched the stipend and it genuinely was his conscience that sent him back to the NHS in Lancashire, so much so that when the three other consultants at his grade in his Health Trust offered him a share of the private work he turned it down.

But that's not the 'real world'.

Hurrumph.

Does that work?

Very good point.

Allow me to a) backtrack a tiny, teensy bit and b) clarify.

I am opposed to a two-tier system where the upper tier gets better quality of care.
Nonetheless, in order to get the best out of a one-tier NHS, I would be in favour of restricting the sort of things that can be treated on the NHS. Curing the very minor ailments such as your example of the common cold for a cost of a billion pounds would be one of those restrictions, as would, for example, vanity boob enlargement or any surgical procedures that cannot be justified on physical or mental health grounds.
We could then sit down and determine what's in and what's out, subject to periodic review etc etc ... but you get the gist.

I had a kidney stone and got absolutely first-class service from the NHS.
However, when I attended a follow-up NHS appointment, the specialist was offhand, terse and rushed as he had a lot of patients to see in a short space of time and I came away confused and worried.
As I had private medical cover and I tend to work away a lot, I booked my next appointment privately at a time to suit me, at a hospital only a couple of miles further away.

The specialist was the same person as I had seen under the NHS ... but this time he had all the time in the world to explain the issues and choices.
This is only one example so doesn't qualify as a scientifically relevant sample but it does seem to me that I got better quality of follow-up care privately than I did on the NHS ... also, while he was attending to me (and for which I feel guilty), there must have been poor sods waiting for a different day ... hence, I believe that private medicine helps people to jump the queue in terms of waiting time and possibly also in terms of whether you actually get the treatment.
It is [uthe same resource[/u, [uthe same specialist[/u and [uthe same specialist's time[/u, indeed the only way I could get to see the specialist on a Monday or Friday was to go private, so speaking about it as though doctors are just doing a bit of work in their spare time is not in line with my experience.

We are talking about health here, one of the basics of life, to which (in my view) all should be entitled ... therefore I cannot diminish it by comparing it with fun stuff like choosing consumer goods such as cars.

It is precisely because, as you put it "[iLife is not fair we all don't have the same intellect, physique, money, upbringing -" [/ithat the likes of you and me should be doing our best to make it as close to being fair as we can. That is the central moral tenet in my life. Indeed, it ought to be the central moral tenet in any country that purports to be Christian.
Unless the good Samaritan in the parable just walked by and said "Well, life's not fair, get used to it".
I'm not a Christian in the religious sense but I am in terms of philosophy and morality.

I cannot contemplate having the meanness of spirit that you seem to be suggesting.

So you got better treatment when the specialist was treating you in his own time - hardly a shock - compared to NHS time when he is obliged to see as many people as he can to reduce waiting times. On that basis you have made a huge assumption that all other specialists are exactly the same.

If your condition is critical 99% of the time the NHS will treat you in the appropriate manner - if it is not it can wait. So if you have the money why should you not be able to spend it on shortening the discomfort - you are not disadvantaging anyone in the queue in fact you are helping them get treated quicker - win win as far as I can see.

You are wrong when you say it is the same resource it isn't - if the specialist decides he doesn't want to do private work that resource evaporates. He isn't going to suddenly going to do the extra hours in the NHS. If BUPA don't build the hospital that also evaporates.

I completely agree regardes certain treatments - IVF should be one that isn't done on the NHS, gender reasignment, some plastic surgery etc.

On life not being far how do make it fair - dumb down the intellegent, scar the beautiful etc it isn't realistic or practical make everyone 6ft tall its crazy. In a civilised society we have to except these differences and move on.

Nobody suggested any such things.

You're simply inventing an entirely spurious idea to justify your own "meanness of spirit", as El Barbudo put it.

If it hadn't been for people in the past who thought differently than you – and fought for what they believed – I very much doubt you'd be in the position you're in today. And if we're a "civilised society", it's because of that.

Grow up - for someone who says she doesn't post on many threads you sure are making a good attempt.

The real world is this - if LGI employed 20 more nurses than it needs it will still be there, these specialists will still have a job - if we employed 20 more printers than we needed we wouldn't and no one would have a job - what bit of this is so difficult for you to comprehend?

Yesterday a print company announced the closure of two of its sites - one totally unionised, one union dominated. The unions have pushed wage rates to uncompetitive levels they have also refused to consider flexible labour because it might have a knock on affect in other chapels. As result everyone will lose their jobs aprox 160 people, this is the real world. This is a profitable company with excellent management, great cash flow etc.

No one can afford labour costs that harm their competitive advantage - something that is completely beyond your comprehension.

I actually think they would - that is, if BUPA (and others) didn't exist then they would negotiate with their NHS Trust to do the extra hours (the hours that they would have been doing privately) within the NHS.

Because there is one thing that drives those who are in a position to negotiate a fixed hours contract with the NHS and insist that they are also allowed one or two days off a week to do private work (usually happens at consultant levels) and that is greed.

Sorry, but its not an overwhelming desire to help humanity cure its bad backs and kidney stones, its the money that can be earned from the profession when you are prepared to put in an extra half or full day shift once or twice a month. Problem is of course that the lifestyle expectations rise to follow the income and before they know whats happened they HAVE to work those extra hours to finance their outgoings - I can't tell you how many pints I've shared with my old mate while he complains about the cost of sending his wife and daughter on their twice yearly shopping trips to New York, "Send them to Primark with my wife and daughter then you f'kin idiot" doesn't seem to wash too well with him.

Said it before and I'll say it again - the printing trade only has itself to blame for union problems, my uncle was a skilled printer until he retired and I've dealt extensively with printing companies in the past, they are the one trade where the 1960s unionised closed shop attitude is still alive and well, and thriving.

We must agree to differ - I have already said these individuals will work more hours than they are contracted for no extra monies in the NHS. The private work enables them the luxuries - private education for their kids etc - that the years of training and skill deserve. Or are we back to the Socialist ideal that these people should earn the same as dustbin man? Greed is a very emotive word something I wouldn't associate with these individuals - they are pretty poor cousins to the dentists and vets of this world and far more skilled and pressured. The chances of someone dying under knife is a bit more serious than if your dog croakes it.

You view about Primark and New York is interesting - I bet when you paint the materials you use are more New York than Primark?

Don't tell me you think SRS is some form of cosmetic procedure?

The Range actually,

and Poundland for the canvas

How many of these consultants were educated and trained by the private sector?

When these private consultants make a balls-up, which private hospital do they ship their patients to, so that they can receive emergency treatment?

Check all the threads on the front page of the [iSin Bin[/i and work out the percentage of those that I post on. Then you can report your findings back here.



You really struggle to understand simple things, don't you? Like bananas. Perhaps when you "grow up" you'll acknowledge that you were wrong about that (and a few other things that you've been pulled on by various people). I'm not holding my breath.

When I mentioned BT, I was talking not of a company that was at risk, but about a company that was making a profit. Because it wanted to make [imore[/i profit – the profit it was making wasn't enough – it sacked people.

In your 'real world', throwing people on the scrapheap is acceptable. Screw them. Screw their families. Screw their lives. Not to save a company that was failing and in danger of going under – but to make [imore[/i profit.

Now, it that the case – ir is it that you don't understand the difference between a company at risk of going bust and one that is making money and simply wants to make more?

Perhaps you imagine that jobs are two a penny and anyone can easily find a new one if they don't like the one they're in (or if they're made redundant)? In which case, to employ your own logic, you have [ichosen[/i to work a full day and effectively subsidise your employer by travelling for three hours either side of that. That, you insisted, is the 'real world'. If that is not the situation and your working arrangements are not a matter of your choice, then it makes your position of being happy to see people thrown on the scrapheap – when there is no threat to the company – even more inexcusable, when you know and understand that they may well struggle to find new work.



So they were making profits, eh?

They weren't actually in danger of going bust, eh?

A company with a substantially unionised workforce was doing well, yes? Making profits, yes? Even with those "uncompetitive" wages?

And since the cost of living is falling rapidly – and has done over the last 30 years – it is entirely reasonable for workers to see their wages fall too, yes?

And the national economy won't suffer, because since it isn't massively reliant on the service and retail sectors, it doesn't need people with money in their pockets to spend?

Yesterday, a mailing house lost a big contract because, after amalgamating with another company, it found it had too much work, and management tried to tell a long-term, major client that it wasn't going to do a pre-booked job and would do it sometime when they found it convenient.

That's 'the real world'.



You really don't care much for your fellow human beings.

1) Kindly quote the place where this is set down as some sort of socialist tenet.

2) Kindly quite where anyone on this forum, in these discussion has ever suggested that this should be the case.

Rationing the number of referrals a GP can make is "reasonable"? How do you work that one out then?

GPs don't refer people just to fill up the time available to NHS consultants, they refer them because there is a clinical need to refer. The rationing of referrals is aimed at reducing cost to the NHS, while still providing the smokescreen of short waiting times. No account is taken of the demographic of a GP's practise or the clinical needs of his patients, that may be well outside of the median.

It is an interesting point - it used to be case but the bigger players are now closing all their unionised sites and keeping open the non-unionised sites. Much to Unite's chagrin

The likes of Sibbald live in a world of their own completely detached from reality. Unite will close every site in which it has a dominant influence.

The issue with print is four fold:
1. Alternative media and the relative ROI on each TV, mobile, Internet etc
2. Over capacity in the market place
3. Rising raw material costs and the inability to pass these costs due to point 2
4. The huge proliferation of pre-packs that are distorting the market place.

Do the German & French printing companies have similar problems with unions?

no mon ami,

just come to france and experience how a real national health system works

our local airport at Limoges ships in dozens of UK NHS patients weekly for treatment in the local hospitals to help lower the UK waiting lists

the system works - it's brill !

You need to read this thread - one poster has said that one of his tenet's of life is that everything should be done to make things fairer and equalise out these quirks of birth.

Socialism can be interpreted in a number of ways - the basic premise suggests wealth is spread more evenly - how do you suggest this is possible when you have the inequalities that basic procreation delivers.

He never has responded to your repeated mentions of the state of affairs on the Continent, has he?

He did not say that everyone should be on the same wage. He did not claim that he believed that the bin man and the surgeon should be on the same rate.

So, where has anyone claimed this?



In the last 30 years, the income gap between those at the very top and everybody else has widened. Just a reflection of the "inequalities that basic procreation delivers", you think?

According to [iThe Spirit Level[/i, countries where there is a wider income gap have greater social problems than countries where there is a narrower income gap. Do you think that this is good? Do you think it acceptable? Do you think that a greater percentage of people in the UK and US are, for instance, somehow genetically predisposed to be worse off than people in, say, Sweden and Japan?

Do you think that Sweden and Japan are socialist countries? Do you think that Sweden and Japan are economic basketcases?