We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

The gamekeeper is on her rounds

“I implore people to stop using private healthcare: it’s killing the NHS”, writes Jessica Arnold, who is described as “associate director of primary care for NHS Bromley clinical commissioning group”.

…this is one of the most insidious and immediate ways privatisation is affecting our universal healthcare system – by poaching staff from their NHS jobs. Private hospitals, private diagnostic testing services, private general practices and other privately run services are creating a vicious cycle of detriment. It is a major contributor to the some 100,000 vacancies currently in the NHS today.

“Poaching” is a strange metaphor to use, given that the “birds” in this case are not being kidnapped by the private sector but leaving the National Health Service to work elsewhere of their own free will. Perhaps Ms Arnold is referring to the eventual destiny of the birds under a gamekeeper’s care that do not get poached.

38 comments to The gamekeeper is on her rounds

  • arkus

    NHS complaints about poaching are a bit rich given their scouring of much of the rest of the world for trained staff.

  • Peter Barrett

    I would assume that Jessica Arnold as “associate director of primary care for NHS Bromley clinical commissioning group” is only too well aware that if the NHS were to stop using and paying for private health services and facilities it would grind to a halt in a very short time.

    All the while private sector investment in health is profitable it will proliferate. All the while the NHS is run and managed as it is currently (by all the Ms Arnolds of this world) private health sector investment will increase in profitability. There is an ultimate conclusion to this scenario.

  • Runcie Balspune

    This is the ugly side of a socialised services showing its real face, when leftists start talking about healthcare being a citizen’s “right” they intentionally ignore the other side of the equation, namely the citizen who needs to provide that service, where are their “rights” in the matter ? The victim painted here is the prospective patient being “denied” a service, but no such victim is the worker who wants to do the right job for the right pay and conditions.

    This is not just restricted to nurses and other medically trained staff, the service is supplied by all manners of work, cleaning, catering, IT, engineering, maintenance, drivers, all of which are monopolised in their career choices by the government institution for the sake of the patient, and as arkus points out, this extends beyond our national borders.

    “private general practices”

    Is there any other type of General Practice? I understood they were all private?

  • Nicholas (Unlicenced Joker) Gray

    Come to that, you already have the Police forces to protect your rights, so when will all private detectives, and security services, be outlawed? Does the UK provide you with a lawyer if you can’t afford one? If so, why not outlaw private lawyers and solicitors? This is a slippery slope indeed!

  • bobby b

    It sucks to get outbid.

    But it just means you bid too low.

  • Jim

    I’m highly pleased that my recent foray into the world of private medicine will be causing the likes of Jessica Arnold even more anguish. My local private hospital has just started a private GP service, I needed to see someone urgently before Christmas so managed to get an appointment. The lady doing the bookings told me that they hadn’t even advertised the service yet it was that new, but she could have booked all the available time slots many times over. It seems like the peasants are looking to overthrow their NHS overlords……….

  • Chester Draws

    But even on her own terms her argument is stupid. It depends on this argument being true

    every nurse or doctor that “defects” to treat private patients could have cared for many more (and needier) NHS patients in a given year.

    But it is merely asserted, not proved. And I strongly doubt it can be proved. The extra service you get will be likely counterbalanced by the requirement to use all resources efficiently in a business. In the meanwhile, the NHS have patients treated for free, and so should have more resources for the others.

    Moreover mostly people go private when it is important. Unless you are very rich, you don’t just get expensive treatment because you can — you get it because you are in pain or at risk of major issues, so the “needier” needs to be shown too, not just asserted. (True the very rich are different, but then there’s not as many of those as the Left think.)

    In other similar situations, you don’t see the private sector grossly wasting resources. When I taught at a private school the class sizes were a little bit smaller, but they made me work more hours to compensate.

    One way to kill the love of the NHS would be to make the royal family wait like everyone else. Why should they queue jump? Britain would be a laughing stock if the Queen couldn’t get a hip replacement for two years because she was too old to be an urgent case!

  • Nicholas (Unlicenced Joker) Gray

    If going private becomes outlawed, then all medical staff become slaves. How would they feel about that?

  • RNB

    “Everything within the state, nothing outside the state, nothing against the state”.

  • Nicholas (Unlicenced Joker) Grayn

    Mossellini! Now where can I pick up my set of steak knives?

  • decnine

    NHS = Slavery. For years they have been instructing patients not to do unapproved things with their own bodies. Now they feel entitled to tell the employees that they may not seek better terms elsewhere.

  • The unspoken question though is “Why do private GP services exist in the first place though Jessica?”.

    It’s not the GP’s and other staff that come first, it’s the demand, which means those poor patient taxpayers that fund your lavish NHS lifestyle have become so sick and tired of having to wait weeks for a non-urgent but necessary GP appointment that they are actually using their own tax-paid cash in the bank to pay for a separate private GP appointment in a timely manner despite already paying for the service that the NHS is unable to deliver.

    It may well be that “The NHS is the national religion of the UK”, but the continued cost and failure of the NHS will lead to it being dissected and put back together as something that actually works this time (like a Swiss style public/private insurance model).

    The sooner, the better.

  • bobby b

    The comments so far (including mine) have focused on how this poorly serves the interests of the NHS employees, but that’s a short-term view.

    This is how the public teachers’ unions (in the US, at least) conquered the competition from private education. They stayed cheap and concentrated on arguments that a unified system was best for the children.

    Then, once the competition was lessened – once the US had almost entirely moved to publicly-financed schools – they switched their efforts to raising their own (now monopoly) compensation.

    So, from a longer view, this is likely a smart argument to make.

  • I seem to recall that even when unions were legalised in the private sector in the United States, they were still illegal in the public sector.

  • Pat

    Doubtless she is also concerned by the patients poached by private providers.
    Should the patients return to the NHS it will need all the staff back to maintain its current level of service. Indeed given its standard of organisation it will probably need more staff than are currently working privately to avoid further deterioration.

  • @Pat – The NHS has already been paid for the “poached” patient and never delivered on anything in the first place. That’s why they went elsewhere and paid twice.

  • bobby b

    “I seem to recall that even when unions were legalised in the private sector in the United States, they were still illegal in the public sector.”

    Strikes by some public employees were illegal for some time, but the teachers’ unions have been active since the early 1800’s.

  • So…

    Private healthcare is a tool to make patients better. Patients are a tool to make the NHS better. Ms Arnold wants us all to be tools.

  • Fred Z

    “associate director of primary care for NHS Bromley clinical commissioning group”

    This person is clearly a paper shuffling, bureaucratic, tax eating, parasite, so her views are as expected.

  • Tim the Coder

    Wasn’t Boris saying only the other day that all departments neded to cut waste?
    Ms Arnold has just identified herself as not required on voyage, and should be shown the door.
    I wonder how her remuneration compares to medical staff? Anyone know?
    I bet this is the tip of an iceberg, and there are whole departments filled of such waste. Time to start solving the problem Boris.

  • Rich Rostrom

    Canada prohibited private medical services for many years. And lots of Canadians went to the US to get their immediately, instead of waiting months or years. There were individual US states that had more MRI machines than all of Canada (and not just California, which has more people; IIRC Michigan, maybe even Washington).

    There were fairly regular reports of Canadian political VIPs going to the US, including noted supporters of Canada’s system.

  • staghounds

    I wonder how many more staff the NHS would be able to hire if Ms. Arnold was willing to work for an orderly’s pay?

  • Chester Draws

    Then, once the competition was lessened – once the US had almost entirely moved to publicly-financed schools – they switched their efforts to raising their own (now monopoly) compensation.

    Not so sure the US teachers are the best examples of this. They do get more than the international wage as teachers, but they also have some of the longest hours.

    Moreover much of the US has a massive teacher shortage, which implies that they aren’t being paid too much.

    I suspect you need to restrict it by state. Some states have more or less crushed the teachers unions, and they pay much less. They also have the biggest shortfall of staff.

    Some states pay teachers very well, and they tend to be the one with the strongest unions. They also, and this is probably more important, tend to be Democrat. It’s not entirely clear which comes first.

    (Given that there is still lots of private schools, some church schools and a whole bunch of charter schools, the argument that the private sector has been shut out of the US is rather odd. The figures I saw show 10% of US is private. That’s a whole pile more than most of Western Europe.)

  • With public sector unions it’s not the rates of pay so much as the pensions and unsackability. If both of those were more in line with the private sector I wouldn’t care so much.

    The whole sticking point with the bankruptcy in Detroit was because the public sector unions refused to renegotiate their contracts, especially the pensions. Just leaching off a city which had largely been abandoned by actual taxpayers and only tax leaches were left, largely the ones that couldn’t afford to leave the city for some place else.

  • bobby b

    “Not so sure the US teachers are the best examples of this. They do get more than the international wage as teachers, but they also have some of the longest hours.”

    You’re telling this to someone who, as a kid, got to spend all of his summers – all three months worth each year – up at our lake cabin with his teaching parents, who had that entire time off. During the nine-month work year, they were always – always – home for dinner at 5:30. And neither spent time after dinner on the apocryphal “grading papers” thing that so many teachers seem to claim.

    “Some states pay teachers very well, and they tend to be the one with the strongest unions. They also, and this is probably more important, tend to be Democrat.”

    This kid’s parents were employed by school districts – in the second half of their careers – in Minnesota, a strongly Democrat state. They made very good money. One of my hobbies now is helping my father administer his $1.5-million portfolio – which he financed solely through retirement and qualified-savings funds from his and my mom’s school employment.

    Our family friends for years were teachers. The public ones – once they hit their 50’s, at least – were prosperous, talking about their mutual funds, lake homes, and new cars. The private school teachers – in my area, mostly Catholic schools, but a few high-end preppie types – were not so prosperous. Private schoolteachers were in it for the love of teaching, or something. They didn’t do nearly as well as the public school types. (Brits would do well to remember that we’all seem to reverse each others’ “public” and “private” terms.)

    Could be specific to my state, I suppose. And, I would hate to be a starting teacher – the pay seems to be poverty for the first eight years, then you make step advancements that make up for all of it after that. But, if I were counseling kids now, I’d send them right into teaching.

  • bobby b

    “With public sector unions it’s not the rates of pay so much as the pensions and unsackability.”

    Unless you’re a male teacher who happens to brush up against or otherwise glancingly touch one of your young charges. Then, you’re distinctly sackable. Which works to the great detriment of students. We’re all taught by females now, all of the time. Because men don’t dare enter the profession.

    (ETA: all of which is entirely OT, so, sorry.)

  • Nico

    Unless you’re a male teacher who happens to brush up against or otherwise glancingly touch one of your young charges. Then, you’re distinctly sackable. Which works to the great detriment of students. We’re all taught by females now, all of the time. Because men don’t dare enter the profession.

    Not in NYC. There are countless stories of NYC public school teachers who at worst get taken off class teaching duty but get to keep their jobs doing not-much.

  • Rob

    This is how the public teachers’ unions (in the US, at least) conquered the competition from private education. They stayed cheap and concentrated on arguments that a unified system was best for the children.

    Then, once the competition was lessened – once the US had almost entirely moved to publicly-financed schools – they switched their efforts to raising their own (now monopoly) compensation.

    But what is the real situation – are teachers a monopoly, and can exploit this for their own gain, or is State education a monopsony which the State can exploit, reducing wages?

  • @Rob – Possibly neither.

    The unions will work with the employer (the state) at the expense of their own members if they can increase their own power and/or line their own pockets. The just need to make sure that their members never find out about it.

  • Rudolph Hucker

    @Arkus

    NHS complaints about poaching are a bit rich given their scouring of much of the rest of the world for trained staff.

    Too true!

    Once upon a time I worked with (redacted medical organisation name). They were targeting UK doctors and nurses that have emigrated to Oz, NZ, Canada, USA, etc. Trying to convince them of the joys of returning to the motherland to work in the NHS. Success rate? Zero percent.

    @John Galt

    The NHS has already been paid for the “poached” patient and never delivered on anything in the first place. That’s why they went elsewhere and paid twice.

    Quite right, as nearly everybody is registered with their local GP, regardless of whether we use the service.

    Is the CCG still the purseholder for the GPs? With funding in proportion to the number of registered patients? IIRC, that was one of the bones of contention between CCGs and GPs (as businesses). Because the CCGs were on a “List Cleaning” programme, trying to clear “dead wood” from the lists (dead, gone-away and deactivated patients don’t get NHS healthcare), to reduce the size of the list, and thereby reducing the GPs income (as businesses).

  • Gene

    With public sector unions it’s not the rates of pay so much as the pensions and unsackability.

    There’s one other element, which you may have meant to imply with that comment, but which should be spelled out because it is so pernicious: Powerful public employee unions (like teachers’) have a lot of money to donate to the campaigns of politicians–politicians who, upon election, are the ones negotiating employment contracts with those very unions. The outcomes are exactly what you would expect.

  • bobby b

    Rob
    January 10, 2020 at 10:43 am

    “But what is the real situation – are teachers a monopoly, and can exploit this for their own gain, or is State education a monopsony which the State can exploit, reducing wages?”

    What do you call a monopsony when the buyer and the sellers are a unified entity?

    The teachers’ unions deliver so much in the way of votes, fundraising, and the brainwashing of future voters to the Democrat politicians that, when in office, those politicians (who sit opposite the unions at the bargaining table) grant them higher and higher wages and better pensions and vast legislative influence.

    The teachers end up being, not employees of the state, but an arm of the state itself, and it’s that combination that becomes the monopoly. They bargain with themselves for good incomes and reduced private-ed possibilities through legislation, and they become the one main seller dealing with the buyers – who are the parents of the kids they’re teaching.

  • Sam

    “Not so sure the US teachers are the best examples of this. They do get more than the international wage as teachers, but they also have some of the longest hours.”

    My wife teaches public elementary/primary school. She makes US$52K/yr for roughly 9.5 months of work. She’s not very organized but manages to get home by 5:00 most days. That’s excellent compensation and workload. The district has to pay that kind of money, however, since the entire public school system is thoroughly broken and every day is another adventure in bureaucratic incompetence, confused direction, passive-aggressive compliance, and essentially a heckler’s veto on anything resembling discipline. So the stress and turnover is pretty high, with each new batch of doe-eyed idealists being ground to a paste by a ruthless centrally-planned clusterf*ck machine designed by and for power-skirts.

    I’d never tell her this, but I think the biggest source of her stress is knowing – really knowing – that she’s failing those kids each and every day.

  • Julie near Chicago

    What about the need to take summer courses in order to keep teachers’ certifications?

    My brother and SIL both used to teach in high school on the Rez in Montana, and had to go to school several summers, of course not the whole summer. The bro brought home homework every night even though he stayed at school late, no nonsense about leaving at 2:30 or whenever the younger inmates were freed for the day, whereas the wife stayed till she finished up grading, making out lesson plans, so forth — I think till around 7-8 p.m. — so she didn’t have to bring it home. And then there’s always administrative paperwork. Have you filled out your forms today?

    I think that one or both of them used to go in on Saturdays also for one reason or another (paperwork, lesson plans, meetings…).

    And teachers have chaperone duties from time to time; dances, ballgames, sometimes long field trips — the bro at least used to take the kids on field trips that could last 2 days at least.

    They constantly complained about the clusterf* that was School. Like Sam’s wife, they were subject to a lot of stress. (Course lots and lots of jobs are stressful — office politics, wayward managers, wayward subordinates, govt. regs.)

    They lasted 15 years. (What “stress & turnover”? /sarc)

    I write this not in defense of the public school, but just because at least some of these teachers actually put in quite a bit more time than many people think. Although it may well be worse in high school than in grade school.

    .

    Sam — I have to tell you that I sympathize with your wife. I daresay you’re right about feeling as if she’s cheating the kids. But … I hope she knows in her head at least that to whatever extent that’s happening, it’s more the System than it is she herself.

    And now that you mention it, I expect my brother & his wife felt that way too, even though I wish they hadn’t taught from a personal viewpoint of Progressivism. And on the other hand, of course they are great big huge supporters of the NEA, so natch brother went to Madison to see that Gov. Walker didn’t mess with the Union. *bleep* Heh!

    . . .

    When I am elected Dictator for Life, there goes the DoE and all gov involvement with education and schools (beyond the usual crimefighting that it should be doing).

  • bobby b

    Julie near Chicago
    January 10, 2020 at 11:56 pm

    “What about the need to take summer courses in order to keep teachers’ certifications?”

    I can only speak about Minnesota. Here, kids stay home for about one day per month for “teacher workshop days.” Teachers spend these days in workshops and courses that keep them current in their continuing education requirements. My dad, early in his Minnesota career, spent one evening per week at the UofM campus for his Masters degree, but that took one year (IIRC) and resulted in a goodly boost to where he was on the step chart for pay. Never do I remember him having to do classes beyond this.

    (He started out teaching in California, in LA, and we lived in near-poverty in Compton during that time. That might have been a function of his lack of seniority, or of Los Angeles poverty itself, or even of the period in which we were there, but that lack disappeared after a few years in Minnesota.)

    “The bro brought home homework every night even though he stayed at school late, no nonsense about leaving at 2:30 or whenever the younger inmates were freed for the day, whereas the wife stayed till she finished up grading, making out lesson plans, so forth — I think till around 7-8 p.m. — so she didn’t have to bring it home.”

    I think the key here is “on the rez.” In Minnesota, grading and admin requirements were handled during one of the teachers’ scheduled “down hours.” That takes money – money to pay for an excess of teachers so as to be able to schedule that way – the kind of money that reservations never see. I know some people teaching in the Pine Ridge and Rosebud reservations in SD. The people who take those jobs have foregone money for something else of value to them. It’s closer to missionary work than normal American teaching.

  • AndyDan

    This is a perfect example of how socialism eventually leads to tyranny. The key worker can’t choose move to a different employer in a different location? Let’s do that too for people in other trades like engineering for example. Niemietz describes it well in his book about Socialism, the failed experiment that never dies. They still want to leave? Let’s build a wall to keep them in. Still won’t play ball? Just kill them.

  • staghounds

    “ruthless centrally-planned clusterf*ck machine”, stolen.

  • Paul Marks

    As others have pointed out above….

    Jessica Arnold is saying that people spending their own money on health care, for for themselves and for other people, is “killing” her free government healthcare.

    So if lots of people, who presently use private health care, were to turn up to the NHS demanding free health care, this (according to Jessica Arnold) would mean that there would be MORE free health care available for people already on waiting lists.

    Think about that – Jessica A. is saying that the laws of supply and demand do-not-exist – indeed that the laws of supply and demand run backwards.

    Jessica A. is saying that adding more people to the waiting lists makes the waiting lists SHORTER.

    adding-more-people-to-the-waiting-lists-makes-the-waiting-lists-SHORTER.

    And that is the sort of person who is in a senior position in the permanent government bureaucracy – not just elected by no one, but also utterly (totally) irrational.

    Utterly, totally, irrational – our rulers, our permanent rulers in the bureaucracy, are insane.

Leave a Reply

You can use these HTML tags

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>