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Showing posts with label cost of the PFI to the NHS. Show all posts
Showing posts with label cost of the PFI to the NHS. Show all posts

Tuesday, 15 May 2012

The Media, the Booze–and the hidden hand of the booze merchants PR machine

I thought of doing a blog on the media response to minimum pricing for alcohol, but since nothing much has changed in their approach since last October, I’ll just re-run this blog from 2011.

But a couple of points -

The ‘penalise the moderate drinker' argument is bollocks – I’m a moderate drinker, I know a lot of moderate drinkers, and none of them will be penalised. Dependent of their choice of tipple, it will either cost them nothing or very little. And if it did result in them – and me - cutting down to low moderate, it would be no bad thing.

The ‘the desperate ones will get it somehow, so price won’t make a difference’ is also bollocks. Addiction, i.e. alcoholism, is a problem for a minority, and as I know from my Glasgow childhood, the desperately poor alcoholic will drink anything – methylated spirits, aftershave, etc. But Scotland’s main problem with alcohol is uncontrolled, excessive social drinking as a lifestyle choice – and it is a choice, especially among the young. Low prices increased this form of drinking and higher prices will reduce this kind of drinking – the evidence is clear.

No one, least of all Nicola Sturgeon, has ever suggested that minimum pricing is a total solution: it is one approach among a complex set of measures, but one that will yield immediate and very tangible results.

I spent fourteen years in the alcohol industry at senior level and worked with them for well over a further decade or more in consulting and training. I know the sophistication and power of their PR and marketing departments, and despite a superficial gloss of “support for encouraging responsible drinking” and token financial support for the councils on alcoholism, etc. their top priorities are volume sales and profitability, and anything that impinges on either will be resisted.

Bluntly, the booze merchants will support any measure. especially the much touted ‘education to change drinking habits’, so long as there is no chance of it actually changing drinking habits and reducing sales of alcohol.

Minimum pricing will change behaviour, it will reduce consumption, it will reduce volume sales, the booze business knows it will – and they will fight it tooth and nail.

MORIDURA BLOG Sunday, 2 October 2011

THE BOOZE –  and “a nice glass of rosé after work”

The Herald and The Scotsman are both panicking about the SNP Government’s measures to combat the twin – and related – Scottish curses of alcohol abuse and sectarianism. Show me a violent bigot and I’ll show you a drunk. They are caught between a rock and a hard place – they must pretend to condemn alcohol abuse and sectarianism, but are terrified that the SNP’s measures might actually succeed in addressing these these ancient evils, because both abuses operate against the Scottish people developing a real national consciousness and democratic will for freedom and independence.

The enthusiasm with which both papers last week seized upon a ‘spontaneous’ demonstration’ - complete with large and elaborately crafted anti-SNP banners - by a small group of old firm ‘fans’ who wanted to protect their right to bellow out sectarian chants - in the name of freedom of expression and sport, God help us – was contemptible.

And today, we have The New Sunday Herald, with an ambivalent front page – Canning the drinks ban – which develops into a thinly-disguised attack on the SNP’s legislative measures to combat cheap booze promotions by supermarkets. Jackie Baillie, Labour, that stout defender of the rights of of Scottish people to have WMDs on their doorsteps and to be protected from any measures that might really help them to stop destroying themselves with cheap hooch, appears rapidly on the scene, accompanied by her sister-in-arms in these matters, Mary Scanlon, Tory, both anxious to shift the attack on alcohol abuse from minimum pricing – which will work - back to the booze barons preferred measures, empty exhortations to behave better (called ‘changing behaviour’) – which manifestly has never worked, and never will work.

Both these women are their party’s Spokeswoman for Health, rather as Tony Blair is Peace Envoy for the Middle East.

The Sunday Herald also wandered into the streets with a camera and picked entirely at random six young Scots who are against the legislation, who all ‘like a nice glass of rosé after work’, or its equivalent, and feel they are being unfairly penalised by the legislation.

They even managed to find a nurse who seemed to be against the legislation, although her views are rather confusing – if reported accurately – since her opening remark calls for ‘an overall ban on low booze prices’, but she feels that ‘it’s ridiculous and might extenuate (sic) other problems in the NHS …” and concludes with The Scotsman’s, The Herald’s, the Tory and Labour spokeswomen for Health’s and the booze business and supermarkets’ favourite solution – ‘dealing with the root cause, by educating people from school level.’

The only thing missing from the nightmare scenario was crazed latte drinkers, driven mad by caffeine.

The Sunday Herald, with no sense of irony, called this ‘sample’ of public opinion VOX POP. Well, I suppose a ‘nice glass of rosé ‘ is as close to pop as you’ll get from a supermarket’s alcohol shelves.

This randomly selected group must be congratulated for standing alone against the consensus of the BMA, the nursing profession, the police, health workers, alcohol and harm reduction workers, etc. who supported minimum pricing and control of price as a desirable and significant move to combat alcohol abuse.

I will find it hard to sleep tonight, thinking of the sad plight of of those unable to afford a nice glass of rosé after work because of this legislation, not to mention those other oppressed Old Firm consumers of rosé at Ibrox or Celtic Park, no longer able to brandish a wee bottle of Mateus on the terracing or bellow out sectarian songs as they wave the flags of nations other than Scotland.

And I will spare a tear for the directors and senior managers of Tesco, crouching round an oil lamp, down to their last few million pounds, as they weep inconsolably over the 0.3% impact on their profits, and desperately try to think up new ways to circumvent the law and democratic government.

Thursday, 2 June 2011

Beating up, humiliating and neglecting the old and vulnerable

The appalling revelations about care homes are shocking, but not new. I watched Question Time last night and was revolted at the attempts of Stephen Dorrell to claim that whether a care home was privately owned or part of the NHS was irrelevant. His attempts to lay it all at Labour’s door (Labour are not free from blame) were desperate, and pathetic.

The Tories, despite their protestations to the contrary, are always in favour of outsourcing vital services for private profit: it is an article of faith with them.

Here are some hard facts, the realpolitik of private profit. In private organisations run for profit where labour costs are not the major part of operating costs, it is possible to recruit employees by a selection process that properly assesses their fitness to carry out the tasks they will be assigned. Effective selection processes are not cheap - they require professional human resources staff and effective selection procedures, including where relevant, psychometric testing.

(As a human resource professional in industry for most of my working life, I used psychometric tests in a test battery designed to assess skills, aptitudes and personality factors relevant to recruiting employees who would interact with people. These tests were not cheap to licence or to apply. If they were relevant to, for example, sales people and customer service employees, they sure as hell are relevant to people carrying out the demanding and stressful work of dealing with the handicapped, the old, the senile the confused and the vulnerable.

How many private care companies use them? Indeed, how widely are they used for this type of employee in the NHS?)

Employees thus selected are therefore equipped physically, intellectually and emotionally to carry discharge their roles, and may also require formal qualifications. Having recruited them, it is almost always necessary to provide further training, including induction training and specialised skills training relevant to the organisation and the demands of the job. That training has to be constantly refreshed and updated.

To find the right employees, the organisation has to offer a remuneration and benefits package sufficient to attract and retain them.

In an organisation where labour costs are the major part of standard operating costs, all of the above costs have to be balanced against the profit objectives of the directors of that organisation.

To put it bluntly, where labour costs are the dominant costs, the goods or services the organisation delivers must be hugely profitable to justify all of the above procedures of recruitment, selection, training and remuneration and benefits. Examples are the law - legal firms, football clubs and high profile brands or hi-tech industries with large profit margins.

Health care - care of the elderly, the chronically sick and the mentally ill or senile - is a labour-intensive, high labour cost industry. When it is run by essentially amoral private companies, the only way to achieve the profit margins required is to either aim at the wealthy and charge high fees, or accept government subsidies and keep the payroll costs as low as possible. Even when government subsidies are adequate, a greedy company will still drive down labour costs.

This commercial cynicism might just be tolerable in an industry supplying a commercial non-essential product or service, but it is not acceptable in a civilised society when applied to the care of human beings.

That is why private health care is never - I repeat, never - an acceptable solution for those who cannot afford to pay inflated fees to private providers.

Sunday, 4 July 2010

The RIE and the PFI

In the early nineties, I was approached by various large private companies – notably civil engineering and building contractors - to provide consultancy advice and negotiating skills training relating to the Public Finance Initiative (PFI).

I waited confidently for the other side of the PFI equation – the public service and local authorities – to approach me for similar advice and training. There were no enquiries. I spent some money on marketing efforts to involve such bodies, but still no interest whatsoever was shown. Since it takes two to tango, it was clear that the so-called public/private partnership was going to be a very unequal one, and that the potential for a major rip-off of the taxpayer existed.

Over the last six months, I have owed my life on four occasions to the NHS – to St. John’s Hospital in Livingston and to the Royal Infirmary of Edinburgh. The new RIE is a wonderful, state-of-the-art facility, matched by dedicated and superbly professional staff at all levels, and many patients owe their lives and the quality of their lives to its existence.

It was with horror and disgust therefore that I had my worst fears confirmed about the operation of the PFI, under the previous Labour/LibDem administration in Holyrood, by the following extract from the Edinburgh West Branch SNP newsletter -

True cost of PFI revealed

Figures from the Treasury, published by the Scottish Parliament, have revealed the staggering cost of Labour's Private Finance Initiative to Scotland's National Health Service. Over the next 30 years, nearly £6.7 billion will leave the NHS in repayments to banks and private operators for PFI projects. The astonishing £6.7 billion of repayments under Labour’s “buy now pay later” policy covers 27 capital projects with an estimated value of only £1.28 billion and comes after £1 billion of repayments have already been made. 

In a flagrant example of Labour’s mismanagement, the taxpayer will pay seven times more for the Edinburgh Royal Infirmary than its original capital cost of £260 million. By last year, that sum had already been paid - but the contracts mean we will keep paying for it for a further 32 years! By 2034, when the contract expires, taxpayers will have paid a jaw-dropping £1.5 billion for the Royal Infirmary alone.