NHS waste - Again!

Most allotments couldn't cope with the needs of a major hospital, with thousands of staff and thousands of patients....

[Ignitionnet]

Originally Posted by Stuart

In my experience, privatisation is the reason behind a lot of the wastage. Certainly when I was working for our local hospital, I raised queries about a *lot* of our contracts when I found we were paying way over the odds for some stuff (e.g. our greengrocer was charging enough that it would have been cheaper to send a member of staff or two over to Sainsburys to get the vegetables every day).

I don't have anything against privatisation as such, but there do need to be adequate controls in place to prevent abuse on both sides, and the government need to take a tougher line when negotiating the contracts. The contracts I've seen define how the government department will behave quite tightly (as they should), but the contractors are often allowed to do pretty much what they want.

If you want to see wholesale abuse of privatisation watch the academy system of schooling go.

There are many ways to make a few quid out of a public contract, even when, in theory, you're serving the public on a non-profit basis. A usual popular one basically boils down to taking kickbacks from suppliers.

[Ramrod]

Lol. So we have members here saying that the way for the NHS to save money is for it to leverage its buying power by purchasing 'stuff' in bulk as a gigantic entity and we have others saying that the way forward is for little bits of it to buy local

[alanbjames]

One thing the NHS here in Wales needs to do is stamp out the use of mobiles for personal use during working hours.

Between the Porter who was texting at every possibility and the Secretary who was doing the same i think the NHS loses a lot of working hours to this.

Oh and also one of the ambulance staff having an argument with his wife on his phone in front of 6 of us patients in the back with him.

[Osem]

Originally Posted by Ramrod

Lol. So we have members here saying that the way for the NHS to save money is for it to leverage its buying power by purchasing 'stuff' in bulk as a gigantic entity and we have others saying that the way forward is for little bits of it to buy local

I don't recall ever getting much of a discount for lack of volume...

There must be loads of basics which could be easily sourced centrally but then there'll be other things which might be better sourced locally. Given the state of the NHS now tough, trying to make sense of it all and undertake a major reorganisation would be fraught with problems.





---------- Post added at 15:07 ---------- Previous post was at 15:06 ----------

Originally Posted by alanbjames

One thing the NHS here in Wales needs to do is stamp out the use of mobiles for personal use during working hours.

Between the Porter who was texting at every possibility and the Secretary who was doing the same i think the NHS loses a lot of working hours to this.

Oh and also one of the ambulance staff having an argument with his wife on his phone in front of 6 of us patients in the back with him.

Cost and I'd imagine a great deal of distraction from more important issues.

[denphone]

You only have to look at the last reorganisation to see how much chaos it did.

http://www.independent.co.uk/news/uk...s-9790247.html

[Gavin78]

I can't see how they say staff have been taking too much leave. the E-roster wont allow you to do that even if the manager allowed you to go into negative hours come the year after when the E-roster allocates the annual leave it will take back the hours over used.

What Leeds hospital trust have been doing is in order to try and get staff to be more resourceful with the equipment they are using is putting the cost per item under the trays/cupboards they are stored in.

For example something like a box of syringes 10ml's £20 for 100 or 2p each we can go through about 400/500 a day.

down to the cost of biscuits they give to the patients £1.10 for Rich tea 70 patients a day 4 on each plate twice a day

It all adds up. but they recently bought some office chairs from their catalogue of approved suppliers £190 each but they were selling the same ones in staples for £90 each.

Bed side tables you know the ones you can wheel under the bed so the top half of the table is across you £250 each

They really do need to crack down on stuff like that.

[heero_yuy]

Originally Posted by Gavin78

It all adds up. but they recently bought some office chairs from their catalogue of approved suppliers £190 each but they were selling the same ones in staples for £90 each.

Bed side tables you know the ones you can wheel under the bed so the top half of the table is across you £250 each

They really do need to crack down on stuff like that.

One of the biggest rackets going across government. On that list and you're in the money. Charge what you like and they'll still buy from you.

Maintanance contracts is another area of waste: I remember when my father ran a recruitment agency he did some calculations on the photocopier contract and concluded it was cheaper to run the thing into the deck and then just replace it than to have it "maintained".

[Osem]

Originally Posted by Gavin78

I can't see how they say staff have been taking too much leave. the E-roster wont allow you to do that even if the manager allowed you to go into negative hours come the year after when the E-roster allocates the annual leave it will take back the hours over used.

What Leeds hospital trust have been doing is in order to try and get staff to be more resourceful with the equipment they are using is putting the cost per item under the trays/cupboards they are stored in.

For example something like a box of syringes 10ml's £20 for 100 or 2p each we can go through about 400/500 a day.

down to the cost of biscuits they give to the patients £1.10 for Rich tea 70 patients a day 4 on each plate twice a day

It all adds up. but they recently bought some office chairs from their catalogue of approved suppliers £190 each but they were selling the same ones in staples for £90 each.

Bed side tables you know the ones you can wheel under the bed so the top half of the table is across you £250 each

They really do need to crack down on stuff like that.

That's just ridiculous. I can understand why those directly involved wouldn't want to admit to the profligacy and wastage but can someone explain to me why the unions, for example, aren't making more of a fuss about this sort of 'criminal' wastage and the cost of using 'approved' suppliers?

[Stuart]

Originally Posted by Ignitionnet

If you want to see wholesale abuse of privatisation watch the academy system of schooling go.

There are many ways to make a few quid out of a public contract, even when, in theory, you're serving the public on a non-profit basis. A usual popular one basically boils down to taking kickbacks from suppliers.

Yep, the one I encountered most was the Variation order. The VO system was OK in theory as it allowed changes to be made to a contract in the event that one of the things defined by that contract was no longer possible (say, a product specified by the contract was no longer available so could be substituted for an equivalent).

What happened was that companies would tender incredibly low prices for some products and higher prices for others. When (or if) the hospital ordered the low priced product, they'd ask for a VO so they could sell an equivalent as the original product was no longer available. Of course, the equivalent would be a lot more expensive.

Of course, I complained about this, and pretty much every member of the administration staff and management I dealt with knew it was happening, but we could do nothing about it.

Originally Posted by Ramrod

Lol. So we have members here saying that the way for the NHS to save money is for it to leverage its buying power by purchasing 'stuff' in bulk as a gigantic entity and we have others saying that the way forward is for little bits of it to buy local

I think the NHS needs to get tougher on it's contractors. It's in a position where it *should* have suppliers almost falling over themselves to supply products to it.

---------- Post added at 18:06 ---------- Previous post was at 17:59 ----------

Originally Posted by heero_yuy

One of the biggest rackets going across government. On that list and you're in the money. Charge what you like and they'll still buy from you.

Maintanance contracts is another area of waste: I remember when my father ran a recruitment agency he did some calculations on the photocopier contract and concluded it was cheaper to run the thing into the deck and then just replace it than to have it "maintained".

We had a contract similar to that. We had heated trolleys for food distribution that were essentially larger, computerised, versions of the "hostess" trolleys that seemed to be all the rage in the 80s.

These trolleys were chosen despite the fact that they apparently were not designed to cope with journeys over tarmac, which did mean they were unsuitable for our hospital, which consisted of one main building, and several smaller outbuildings (one of which was the kitchen), all joined by tarmac roads.

As such, they broke down regularly. We paid maintenance on them, but each time one broke down, it would cost at least £500 to repair, and we had at least one trolley out of action at any given time.

TBH, I'm not entirely sure what the computer did, apart from bump up the price and maintenance costs.

[Arthurgray50@blu]

I think most public service companies are ripped off. Company that l work with, l am always complaining about the servicing of cycles and purchasing them.

I used to build bikes as a kid, we had an agent that would take a 'simple' repair away for several weeks. When a cycle dealer could repair within 24 hours at a reasonable price.

And yet, we were advised that a new cycle, would cost £700 BUT, l can but the SAME cycle from a cycle shop for £150

Its a rip off that makes me really annoyed at the time, we are trying to make cutbacks.

[Gavin78]

I think in terms of "approved suppliers" it's more to do with insurance costs e.g. who is going to be using that piece of equipment and is it safe to use.

I can only assume perhaps extra checks are done on the equipment by the supplier or they are more liable in the event something happens while in use I'm not sure.

all I know is we have a cataluge for ordering stock and has to be use for buying equipment.

But here is some red tape. We had a patient that was of obese size they needed a bariatric bed and we only have the standard size beds you'll have all seen when staying in the NHS. he was well within the weight of these beds but their overall size was too big for the standard bed.

So because we didnt know how long we were having this patient they had to hire an extra large bed. The cost per week was £1500 out of our ward budget or the bed was £4000 to buy.

We had to wait 2 weeks for the Back care advisor to come and look at the bed do a report on it. wait for the report to come back send the report off to the Matron along with costs per year hire vs buying wait for the Matron to look at the report, then she had to send off the report with her findings to the board of directors that over see our wards. once they had approved it all it then had to go to a finance director who approves budgets to be spent out of ward funds.

This all took 6 months, they finally got approval to buy the bed and got a discount and paid £3500.

So to rent the bed I think worked out at about 35k plus 3.5k to buy. the patient 3 weeks later got really unwell to the point they couldn't cope with the treatment we were giving and finally moved off the ward to more intensive care and the bed we paid has been in storage ever since off site.

As the ward they went to have the beds for people their size so didn't need ours

[Osem]

So complying with all the 'paperwork' meant that a £4000 bed wound up costing the NHS nearly 10 times that not to mention the time/cost of the whole process!

Surely, when the cost of hiring is such a large proportion of the purchase price it has to be better and much cheaper to just go out and buy the item. If the point of producing/authorising the reports is to save money, surely someone needs to make an initial judgement as to the value of so doing in cases such as this. It doesn't take a mathematician to see that the time taken to do the paperwork etc. will far outweigh the full cost of the items concerned in no time at all. It's maddening!

[Ignitionnet]

Originally Posted by Osem

So complying with all the 'paperwork' meant that a £4000 bed wound up costing the NHS nearly 10 times that not to mention the time/cost of the whole process!

Surely, when the cost of hiring is such a large proportion of the purchase price it has to be better and much cheaper to just go out and buy the item. If the point of producing/authorising the reports is to save money, surely someone needs to make an initial judgement as to the value of so doing in cases such as this. It doesn't take a mathematician to see that the time taken to do the paperwork etc. will far outweigh the full cost of the items concerned in no time at all. It's maddening!

These things have to be logged in depth with tons of paperwork to ensure that people like you can bitch about them I'm afraid.

The worse a public service appears to be the better an argument can be made to increase the involvement of the private sector, and all those Tory ministers and MPs with fairly close connections to those seeking to profit from the NHS can make a few quid and/or win some favours.